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The University of Cincinnati College of Medicine, TG Medical Education for Pharmacists, and The Illinois Nurses Association invite you to a live, continuing medical education audioconference program.

This accredited audioconference program is supported by an independent educational grant from Astellas Pharma Global Development, Inc.

Joseph G. Verbalis, MDProfessor, Department of Medicine Chief, Division of Endocrinology and MetabolismGeorgetown University Hospital Washington, DC

Live Program Schedule

Monday November 2 1:00 PM (EST)

Tuesday November 17 2:00 PM (EST)

Monday November 30 3:00 PM (EST)

Tuesday December 15 12:00 NOON (EST)

Call (877) 603-2497 to Participate

Hyponatremia: Strategies for Appropriate Diagnosis and Intervention

Current Guidelines in Management of Hyponatremia in Adult Patients

P r o G r a M o V e r V i e wHyponatremia is the most common disturbance of fluid and electrolyte balance, occurring frequently in hospitalized and nursing home patients with many different types of disorders. Hyponatremia is usually mild and relatively asymptomatic; however, acute severe hyponatremia can cause substantial morbidity and mortality, particularly in patients with concomitant disease. In addition, overly rapid correction of chronic hyponatremia can also cause severe neurologic deficits and death. Optimal treatment strategies to avoid both of these adverse outcomes for such cases have not been clearly established.

Hyponatremia may occur in patients who are volume depleted, edematous, or clinically euvolemic. Regardless of volume status, the vast majority of cases are associated with impaired water excretion caused by the antidiuretic hormone, vasopressin. Some of the most common causes include:

the syndrome of inappropriate antidiuretic hormone secretion (SIADH) due to cancers, neurological diseases, and pulmonary and endocrine disorders

edema-forming states such as congestive heart failure and cirrhosis

the use of many different drugs, including some antidepressants, antiepileptics, cyclophosphamide, and NSAIDs

postoperative nonosmotic vasopressin release in combination with excessive administration of hypotonic fluids after surgery

Although morbidity varies widely in severity, serious complications can arise from either the disorder itself or during treatment. Because the morbidity and mortality of both untreated and improperly treated hyponatremia are clinically significant, it is important that clinicians fully understand the presentation, pathophysiology, and treatment options for hyponatremic patients.

Ta r G e T a u D i e n c eThis audioconferences series and newsletters are intended for healthcare professionals who treat hyponatremia.

a c c r e D i TaT i o n f o r P h y S i c i a n SThis activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME). The University of Cincinnati is accredited by the ACCME to provide continuing medical education for physicians. The University of Cincinnati designates this educational activity (each audioconference) for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

ACPE Program # 454-999-09-012-H01-P

Current Guidelines in Management of Hyponatremia in Adult Patients

a c c r e D i TaT i o n f o r P h a r M a c i S T S This program is approved for one (1) hour credit (0.1 CEUs) and is co-sponsored by TG Medical Education who is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. A statement of CE credit will be mailed within 4 to 6 weeks of successful completion and evaluation of the program. Please note there are 4 different ACPE program numbers specific to each audioconference.

a c c r e D i TaT i o n f o r n u r S e S This continuing nursing education activity was approved by The Illinois Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

f a c u L T y D i S c L o S u r eAll faculty participating in continuing education activities sponsored by The University of Cincinnati, TG Medical Education and The Illinois Nurses Association are expected to disclose to the audience any real or apparent commercial or financial affiliations related to the content of their presentations.

Dr. Joseph Verbalis has no disclosures for this particular presentation.

PartiCiPation instruCtionsIf you are listening to the conference with colleagues, you will need a touch-tone phone with a built-in speaker mechanism.

Call in to the conference 5 to 10 minutes prior to the scheduled start time.

The operator will ask for the title of the presentation or speaker name, and then the name under which you are registered.

Press the digits *1 on your touch-tone phone at any time during the conference to be put in the cue for questions following the program.

All questions will be answered on a first-come, first-served basis.

The conference will last approximately 60 minutes.

instruCtions for obtaining CME/CPE/CEu CrEditTo obtain CME/CPE/CEU credit, please complete the enclosed evaluation form or fax it to 1-312-873-3906. Your CME credit will be processed and mailed to you within approximately 4 weeks.

Or you can complete the evaluation form online at www.PharmEdinternational.com/HYPo

If you complete the form online, you can print your own CME certificate immediately.

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The University of Cincinnati, TG Medical Education for Pharmacists, and The Illinois Nurses Association appreciate your comments on this meeting. Your input will help us improve our future programs.

A certificate of completion is issued upon receipt of your completed evaluation form

Program Date: _____________________________________ Speaker: Joseph G. Verbalis, MD

Please answer the following questions 5 = Outstanding 2 = Fair by circling the appropriate rating: (circle one) 4 = Good 1 = Poor 3 = Satisfactory

Extent to Which the Program Met the Learning Objectives

Understand the many different pathophysiologies underlying acute and chronic hyponatremia 5 4 3 2 1

Review current and future indications for the treatment of hyponatremia in inptietns and outpatients 5 4 3 2 1

Discuss potential problems associated with correction of hyponatremia and strategies to avoid them 5 4 3 2 1

Effectiveness of the Speaker: Joseph G. Verbalis, MD

Knowledge of subject matter 5 4 3 2 1 Ability to provide practical clinical information 5 4 3 2 1

Is there anything you would like to communicate directly to the speaker?

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Overall Effectiveness of the Activity Relevant to my practice needs 5 4 3 2 1 Audioconference format was conducive to learning 5 4 3 2 1 There was sufficient time for questions and answers 5 4 3 2 1 Handout materials were useful 5 4 3 2 1 Avoided commercial bias or influence 5 4 3 2 1

Following completion of this program, what will you do differently in the care of your patients?_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

Please list other topics that would be of interest to you for future educational activities:

_______________________________________________________________________________________________________

_______________________________________________________________________________________________________

To receive credit for this activity, please PRINT CLEARLY your contact information and: FAX to 312-873-3906

1. Participant: First Name_______________________________________ Last Name ________________________________________

Degree ____________________ Street Address ____________________________________________________________________

Box/Suite # ______________ City ___________________________________ State _________ Zip _________________________

Phone Number _______________________________ Company/Institution _______________________________________________

2. Please indicate the certificate you qualify for: q Physician CME q Nursing CE q Pharmacy CPE q Certificate of Participation

3. How would you like to receive your certificate? (Please print clearly)

Email Address ___________________________________________________________________________________________________

Would you like to receive the follow-up program newsletter via email? q YES q NO

Fax Number ________________________________________________ q US Mail (Same as above)

Project ID: 300.51FAX to: (312) 873-3906ACPE Program # 454-999-09-012-H01-P

Evaluation Form for Hyponatremia Audioconference ProgramCurrent Guidelines in Management of Hyponatremia in Adult Patients

This Live CME/CPE Audioconference and Newsletter program is supported by an independent educational grant from Astellas Pharma Global Development, Inc.

Copyright©2009 PharmEd International, Inc.206 S. Jefferson Street, Chicago, IL 60661