CEimpact Podcast

Irritable Bowel Syndrome (IBS) is a common disorder that greatly affects quality of life. Several medications have been approved for use in IBS – both constipation (IBS-C) and diarrhea (IBS-D). The American Gastroenterological Association just released guidelines provide evidence-based recommendations for patients.

The GameChanger 
In the last 10 years several pharmacotherapies have been FDA approved for both constipation IBS-C) and IBS-D. Updated guidelines from the AGA review the literature surrounding these and other therapies for evidenced based guidelines update. For example, secretagogues such as linactolide are now first line treatment after PEG laxatives for IBS-C 

 
Show Segments 
00:00 – Introduction 
01:28 – Irritable Syndrome (IBS) Bowel Background 
04:04 – AGA Evidence-Based Recommendations  
06:33 – IBS-D Recommendations  
14:29 – IBS – D and IBS – C Recommendations 
17:39 – IBS – C Recommendations 
26:54 – Closing Remarks 

Host
Geoff Wall, PharmD, BCPS, FCCP, CGP 
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health 

 
References and resources:
AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation

 
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Continuing Education Information:
Learning Objectives:
1. Discuss the pharmacologic and non-pharmacologic therapies for treatment of Irritable Bowel Syndrome-Constipation
2. Discuss the pharmacologic and non-pharmacologic therapies for treatment of Irritable Bowel Syndrome-Diarrhea


0.05 CEU | 0.5 Hrs
ACPE UAN: 0107-0000-22-282-H01-P
Initial release date: 08/15/22
Expiration date: 08/15/2023
Additional CPE & CME details can be found here

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The United States Preventative Services Task Force issued new recommendations for the use of vitamins, minerals, and multivitamins for the prevention of cardiovascular disease and cancer. This is a revision from the 2014 recommendations and is based on recent data. Host Geoff Wall will provide a review of the recommendations – and evidence on these over-the-counter products.

The GameChanger 
Based on the new USPSTF recommendations, most vitamins and supplements have insufficient data to determine their benefits versus harm. However, the USPSTF recommends against the use of beta carotene or vitamin E supplementation for the prevention of cancer or cardiovascular disease.  

Show Segments 
00:00 – Introductions 
01:15 – Vitamins, Minerals, and Supplements Regulations and Controversies 
06:11 – USPSTF Recommendations 
10:07 – Beta Carotene in Cancer and Cardiovascular Disease 
11:49 – Vitamin A Supplementation 
12:14 – Vitamin E Supplementation 
12:52 – Multivitamin Use 
15:16 – Vitamin D & Calcium Supplementation  
17:40 – Folic Acid Supplementation  
18:50 – Vitamin C Supplementation  
19:05 – The GameChanger 
22:58 – Connecting to Practice 
23:40 – Closing Remarks 

 Host
Geoff Wall, PharmD, BCPS, FCCP, CGP 
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health 

References and resources:
US Preventive Services Task Force. Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement.

Redeem your CPE or CME credit

• CPE (Pharmacist)
• CME (Physician)

Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

• Pharmacists: Get a Membership 
• Prescribers: Get a Membership  

 
Continuing Education Information:
Learning Objectives:
1. Discuss the use of vitamin E for cardiovascular disease prevention
2. Describe the USPSTF recommendations for vitamins, minerals, and multivitamins


0.05 CEU | 0.5 Hrs
ACPE UAN: 0107-0000-22-281-H01-P
Initial release date: 08/08/22
Expiration date: 08/08/2023
Additional CPE & CME details can be found here

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Calculating an accurate renal function in patients is crucial to ensure the right dose gets to the right patient. Previous equations to estimate glomerular filtration rate depended on a race variable. However, recent data suggests this underestimates the risk of chronic kidney disease in black patients. In this episode, host Geoff Wall discusses different methods to calculate kidney function and the relationship between mortality, kidney failure, and race 

The GameChanger 

The newly proposed eGFRcr-cys equation was the most accurate in estimating the relationship of GFR to poor outcomes regardless of race. However, even with this equation, black patients were almost uniformly found to have poorer outcomes than non-black patients 

Show Segments 
00:00 – Introductions 
01:30 – Kidney Function and Kidney Disease 
03:00 – Estimating Kidney Function Based on Race 
07:44 – Cystatin C vs Creatinine Clearance  
09:57 – Association of Estimated GFR Calculated Using Race-Free Equations with Kidney Failure and Mortality by Black vs Non-Black Race   
16:11 – The GameChanger  
19:25 – Connecting to Practice 
21:16 – Closing Remarks  

Host
Geoff Wall, PharmD, BCPS, FCCP, CGP 
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health 

 
References and Resources 

Association of Estimated GFR Calculated Using Race-Free Equations with Kidney Failure and Mortality by Black vs Non-Black Race 

Redeem your CPE or CME here 

CPE (Pharmacist)  

CME (Physician)  

 
Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

Pharmacists: Get a membership 

Prescribers: Get a membership 

CE Information
Learning Objectives 

Upon successful completion of this knowledge-based activity, participants should be able to: 

1. Describe the equation that best estimates risk of poor outcomes in patients with chronic kidney disease regardless of race 

2. List barriers to implementing cystatin-C testing in clinic laboratories 

0.05 CEU/0.5 Hr 

UAN: 0107-0000-22-280-H01-P 

Initial release date: 08/01/2022 

Expiration date: 08/01/2023 

Additional CPE and CME details can be found here. 

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A NON-endemic spread of monkeypox has been reported in multiple countries – a phenomenon that has never happened before. The Centers for Disease Control and Prevention and the World Health Organization are developing plans for potential outbreaks – what are the 101s on this disease for healthcare providers?

The GameChanger 
Most cases of monkeypox are self-limiting, but death rates up to 10% have been reported, particularly in children and immunosuppressed patients. Treatment options for monkeypox exist but have not been evaluated in large studies to prove efficacy or safety.  

Show Segments 
00:00 – Introductions 
01:24 – Monkeypox Background  
08:29 – Monkeypox Presentation  
09:32 – Combating & Treating Monkeypox 
21:21 – Closing Remarks 

 
Host
Geoff Wall, PharmD, BCPS, FCCP, CGP 
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health 

References and resources:

• CDC. Monkeypox and Smallpox Vaccine Guidance. 
• WHO. Multi-country monkeypox outbreaks in non-endemic countries. 
• Clinical features and management of human monkeypox: a retrospective observational study in the UK.

Redeem your CPE or CME credit

• CPE (Pharmacist)
• CME (Physician)

Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

• Pharmacists: Get a Membership 
• Prescribers: Get a Membership 

Continuing Education Information:
Learning Objectives:
1. Describe the symptoms and signs of monkeypox
2. Discuss current status of vaccines against monkeypox in the US 

0.05 CEU | 0.5 Hrs
ACPE UAN: 0107-0000-22-276-H01-P
Initial release date: 07/25/22
Expiration date: 07/25/2023
Additional CPE & CME details can be found here

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Several large observational studies have suggested metformin has anti-tumor effects and may be beneficial as an adjunctive treatment option for breast cancer. This hypothesis was tested by a randomized clinical trial recently published. Listen to host Geoff Wall discuss if metformin is a miracle drug. 

The GameChanger 

Metformin can alter insulin signaling which is crucial for the development of certain types of cancer cells. Thus, in various observational and pre-clinical studies, metformin has been associated with better outcomes in breast cancer, usually in patients with diabetes. A recently published RCT found no benefit of taking adjunctive metformin in patients with breast cancer and no diabetes.  

Show Segments 

00:00 – Introductions 
01:19 – Metformin in the Treatment of Breast Cancer 
02:21 – Insulin Signaling in Tumor Cell Development  
06:54 – Effect of Metformin Vs Placebo on Invasive Disease-Free Survival in Patients with Breast Cancer: The MA.32 Randomized Clinical Trial 
17:09 – Connecting to Practice & Further Studies  
21:17 – The GameChanger 
21:55 – Closing Remarks 

Host 

Geoff Wall, PharmD, BCPS, FCCP, CGP
Professor of Pharmacy Practice, Drake University
Internal Medicine/Critical Care, UnityPoint Health


References and Resources 

Effect of Metformin vs Placebo on Invasive Disease–Free Survival in Patients With Breast Cancer: The MA.32 Randomized Clinical Trial


Redeem your CPE or CME here 

CPE (Pharmacist) 
CME (Physician)  

 
Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

Pharmacists: Get a membership
Prescribers: Get a membership 

 
CE Information
Learning Objectives 

Upon successful completion of this knowledge-based activity, participants should be able to: 

1. Describe the potential mechanism(s) of action of metformin as an anti-tumor agent 
2. Discuss the MA.32 study and role of metformin in breast cancer treatment 

 0.05 CEU/0.5 Hr
UAN: 0107-0000-22-248-H01-P
Initial release date: 7/18/22
Expiration date: 7/18/23
Additional CPE and CME details can be found here. 

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Nirmatrelvir-Ritonavir continues to be recommended for outpatient treatment of COVID-19 infections, especially as cases continue to rise. However, this therapy does present clinical challenges – from drug interactions to off-label dosing and rebound COVID-19 infections, therapy is not as easy as it sounds. Listen as host Geoff Wall describes the clinical challenges and guest Jake Galdo describes the public health considerations for nirmatrelvir-ritonavir use.

The GameChanger 
Nirmatrelvir-ritonavir has significant clinical challenges including various drug interactions with DOACs, statins, amiodarone, and tacrolimus, for example. It’s also important to note that COVID-19 rebound after nirmatrelvir-ritonavir is not due to resistance based on the latest data.

Show Segments 

00:00 – Introductions 
01:25 – Nirmatrelvir-Ritonavir Updates 
04:27 – Nirmatrelvir-Ritonavir Controversy  
06:30 – Drug Interactions  
08:05 – DOACs and Nirmatrelvir-Ritonavir  
11:44 – Statin and Nirmatrelvir-Ritonavir 
13:04 – Amiodarone and Nirmatrelvir-Ritonavir 
15:02 – Tacrolimus and Nirmatrelvir-Ritonavir  
19:33 – COVID-19 Rebound  
23:38 – Equity and Access 
31:44 – Closing Remarks 

Host
Geoff Wall, PharmD, BCPS, FCCP, CGP 
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health 

Guest
John A. Galdo, PharmD, MBA, BCPS, BCGP (Jake)
Course Content and Developer, CEimpact
Pharmacist, Ross Bridge Pharmacy
CEO, Seguridad, Inc

Dr. Galdo have no relevant financial relationships to disclose.

References and Resources

• University of Liverpool Drug Interactions 
• CDC Health Advisory on COVID Rebound Infections
• Paxlovid Patient Eligibility Screening Checklist Tool for Prescriber

Redeem your CPE or CME credit

• CPE (Pharmacist) 
• CME (Physician) 

Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

• Pharmacists: Get a Membership
• Prescribers: Get a Membership  

Continuing Education Information

Learning Objectives:
1. Explain common drug interactions associated with Nirmatrelvir-Ritonavir
2. Discuss COVID ‘rebound’ infections
3. Describe public health and healthcare data considerations for Nirmatrelvir-Ritonavir use
 
0.05 CEU | 0.5 Hrs
ACPE UAN: 0107-0000-22-247-H01-P
Initial release date: 07/11/22
Expiration date: 07/11/2023
Additional CPE & CME details can be found here

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Curious about tirzepatide and what it means for patients? Tirzepatide, a combination GLP-1 and GIP agonist, was just approved by the Food and Drug Administration for the treatment of diabetes. Tirzepatide has also gained attention for its weight-reducing effects. However, how does tirzepatide compare to other GLP-1 agonists? Is tirzepaide a GameChanger for type 2 diabetes management? Learn more with host, Geoff Wall. 

 The GameChanger 
Tirzepatide is the first in its class to hit the market and has been shown to be as or more effective than semaglutide in glycemic control and weight reduction.  

 Show Segments 
00:00 – Introductions 
01:15 – Type 2 Diabetes & Treatment 
02:29 – Glucagon-like peptide-1 (GLP-1) Agonists 
03:04 – Glucose-dependent insulinotropic polypeptide (GIP) Agonist   
03:55 – Tirzepatide vs Semaglutide 
14:27 -  Tirzepatide vs Insulin 
21:15 – Retinopathy & Financial Considerations 
22:30 – Closing Remarks  

Host
Geoff Wall, PharmD., BCPS, FCCP, CGP 
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health 

References and Resources 

• Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes 
• Once-Weekly Tirzeaptide Versus Once-Daily Insulin Degludec as Add-On to Metformin With or Without SGLT2 Inhibitors in Patients With Type 2 Diabetes (SURPASS-3): A Randomized, Open-Label, Parallel-Group, Phase 3 Trial  
• Efficacy and Safety of a Novel Dual GIP and GLP-1 Receptor Agonist Tirzepatide in Patients With Type 2 Diabetes (SURPASS-1): A Double-Blind, Randomised, Phase 3 Trial 
• Effect of Subcutaneous Tirzepatide vs Placebo Added to Titrated Insulin Glargine on Glycemic Control in Patients With Type 2 Diabetes: The SURPASS-5 Randomized Clinical Trial 

Redeem your CPE or CME here 

• CPE (Pharmacist)  
• CME (Physician)  

Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

• Pharmacists: Get a membership 
• Prescribers: Get a membership 

CE Information
Learning Objectives 

Upon successful completion of this knowledge-based activity, participants should be able to: 

1. Describe the safety and efficacy of tirzepatide compared to GLP-1 agonists 
2. Discuss the use of tirzepatide compared to basal insulin for blood glucose control 
3. Select a patient who may be a candidate for tirzepatide therapy 

0.05 CEU/0.5 Hr
UAN: 0107-0000-22-234-H01-P
Initial release date: 06/27/2022
Expiration date: 06/27/2023
Additional CPE and CME details can be found here. 

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They are finally here! COVID-19 vaccines for children as young as 6 months. The FDA’s advisory committee unanimously voted to authorize vaccines from Pfizer & BioNTech and Moderna. But now the question, which one is best?

 *Note, per the PREP Act, pharmacists, pharmacy technicians, and pharmacy interns may administer COVID-19 vaccines to individuals as young as 3 years.
 
Host
Geoff Wall, PharmD., BCPS, FCCP, CGP 
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health

Guest
John A. Galdo, PharmD, MBA, BCPS, BCGP (Jake)
Course Content and Developer, CEimpact
Pharmacist, Ross Bridge Pharmacy
CEO, Seguridad, Inc

Redeem your CPE or CME credit

• CPE (Pharmacists)
• CME (Physicians)

Get a membership & earn CE for GameChangers Podcast episodes

• Pharmacists: Get a membership
• Prescribers: Get a membership

 References and Resources

• Vaccines and Related Biological Products Advisory Committee June 14-15, 2022 Meeting Materials
• FDA meeting for < 5 COVID vaccine: Q&A
• COVID-19 vaccine info for trusted messengers: Kids < 5 years
• COVID-19 vaccines: What you need to know about COVID-19 vaccines

 Continuing Education Information
Learning Objectives:
1. Describe the efficacy and safety of COVID-19 vaccines in patients under the age of 5
2. Discuss common questions that the potentially vaccine hesitant parent may have about these vaccines

All relevant financial relationships have been mitigated.

0.05 CEU | 0.5 Hrs
ACPE UAN: 0107-0000-22-275-H06-P
Initial release date: 6/27/22
Expiration date: 6/27/2023
Additional CPE & CME details can be found here

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Adequate risk assessment and management are crucial in preventing cardiovascular disease. A recent study examined the correlation between common measures of cholesterol concentration versus the number of apolipoprotein B (apo-B)-containing lipoproteins. In other words, should clinicians use different biomarkers for cardiovascular risk assessment? Cardiology Pharmacist, Lindsay Davis, joins Geoff Wall in this discussion.

The GameChanger 
Evidence is emerging to suggest apo-B is a more accurate biomarker of MI risk. While not routinely evaluated, apo-B is a GameChanger in that it can be helpful in determining cardiovascular risk in patients with borderline risk factors.  

 Show Segments 

00:00 – Introductions 
03:22 – Apolipoprotein B (apo-B) 
05:22 – Biomarkers for Cardiovascular Disease 
12:58 – The GameChanger 
20:37 – Connecting to Practice 
28:49 – Closing Remarks 

Host
Geoff Wall, PharmD., BCPS, FCCP, CGP
Professor of Pharmacy Practice, Drake University
Internal Medicine/Critical Care, UnityPoint Health

Guest:
Lindsay Davis, PharmD, BCPS, BCCP, TTS, ASH-CHC
Professor, Midwestern University

Lindsay Davis has no relevant financial relationships to discuss.

References and resources:

• Association of Apolipoprotein B–Containing Lipoproteins and Risk of Myocardial Infarction in Individuals With and Without Atherosclerosis Distinguishing Between Particle Concentration, Type, and Content
• AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY GUIDELINES FOR MANAGEMENT OF DYSLIPIDEMIA AND PREVENTION OF CARDIOVASCULAR DISEASE
• Primary biliary cirrhosis, hyperlipidemia, and atherosclerotic risk: a systematic review
• 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines

Redeem your CPE or CME credit

• CPE (Pharmacists)
• CME (Physicians)

Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

• Pharmacists: Get a membership
• Prescribers: Get a membership

Continuing Education Information:
Learning Objectives:
1. Describe the role of apolipoprotein B in cardiovascular management
2. Identify patients that may benefit from apolipoprotein B testing

All relevant financial relationships have been mitigated. 

0.05 CEU | 0.5 Hrs
ACPE UAN: 0107-0000-22-232-H01-P
Initial release date: 06/20/22
Expiration date: 06/20/2023
Additional CPE & CME details can be found here

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Transgender individuals are more likely to receive unequal care and are less likely in general to seek care or preventative services. Often, they are even relied upon to educate their own providers on the basic tenets of transgender care. Healthcare providers can better serve these patients through an interprofessional approach to comprehensive, respectful, and gender-affirming support. Listen in to this week’s episode as Dr. Anisa Hansen describes important steps we can take to have a positive impact on the health of this patient population.

The GameChanger
Just like any other therapy, gender-affirming therapy should be patient-focused, with the patient's goals in mind. Healthcare providers will continue to be called upon to safely monitor these therapies and support their patients. The first and most important step is making a welcoming environment for patients and being both knowledgeable and open to how to best support and treat each patient. 

Show Segments
00:00 – Introductions
02:50 – Common Terminology 
07:00 – Pronouns 
08:00 – Social & Legal Affirmation
09:45 – Issues Surrounding Gender Affirming Care
10:59 – Hormone Therapy for Non-Binary Individuals 
13:00 – Masculinizing Gender Affirming Hormone Therapy
18:31 – Feminizing Gender Affirming Hormone Therapy
22:30 – Additional Resources
22:35 – Closing Remarks 

Host
Geoff Wall, PharmD., BCPS, FCCP, CGP
Professor of Pharmacy Practice, Drake University 
Internal Medicine/Critical Care, UnityPoint Health

Guest
Anisa Hansen, PharmD.
Associate Professor of Pharmacy Practice, Drake University
Mental Health Clinical Pharmacists, Iowa Lutheran Hospital 

Anisa Hansen has no relevant financial relationships to discuss.

Anisa Hansen has a passion to educate learners on topics in the areas of mental health, LGBTQ health, wellness, and equity and inclusion. Anisa provides clinical service, educates sixth-year pharmacy students, and provides medication education groups in both the outpatient and inpatient setting.
 
References and Resources
The World Professional Association for Transgender Health
The Journal of Clinical Endocrinology & Metabolism
UCSF Transgender Care

Want to learn more about this topic and earn more CE?
Gender Affirming Care for Transgender and Gender Non-Conforming Patients – Pharmacist Gender Affirming Care for Transgender and Gender Non-Conforming Patients – Technician

Redeem your CPE or CME 

• CPE (Pharmacists)
• CME (Prescribers)

Get a membership & earn CE for GameChangers Podcast episodes (30 mins/episode) 

• Pharmacists: Get a membership
• Prescribers: Get a membership

CE Information
Learning Objectives
Upon successful completion of this knowledge-based activity, participants should be able to:
1. Define terminology associated with gender-affirming care
2. Discuss masculinizing treatment options

0.05 CEU/0.5 Hr
ACPE UAN: 0107-0000-22-231-H01-P
Initial release date: 06/13/2022
Expiration date: 06/13/2023
Additional CPE and CME details can be found here

Follow CEimpact on Social Media:
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