speed dating with pharmacists: 50 practical medication tips at end of life (406)

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Objectives 1. Identify diagnoses which are ethically appro- priate for perinatal palliative care. 2. Describe the limits of parental autonomy in terms of requesting or refusing life-pro- longing treatment in the neonatal period. 3. Identify the role of conscientious refusal on the part of professionals, especially with re- gard to palliative care of infants who might survive. The American Academy of Pediatrics ‘‘supports an integrated model of palliative care in which the components of palliative care are offered at diagnosis and continued throughout the course of illness.’’ A prenatal diagnosis of a life-limiting condition therefore requires not only care for the baby after birth but also of the mother and fetus during pregnancy and delivery. This raises a host of ethical issues for the obstetrical and pediatric teams, as they weigh often-competing obligations to mother and fetus. This session will begin with an obstetrician and a pediatric palliative care consultant discussing the obligation to accede to maternal request for caesarian section for a fetus with Trisomy 13. The short- and long-term complications of C-section are well-knowndand felt to be accept- able risks when the expected outcome is a healthy mother and a healthy neonatedbut does a mother’s wish for a baby born alive justify these in the context of a lethal anomaly? Next a pediatric intensivist and ethicist will ex- plore the limits of parental autonomy in neonatal decision-making. The AAP specifies certain conditions (such as extreme prematurity, anen- cephaly, and Trisomy 13) as appropriate for non-resuscitation in the delivery room, but what if the family requests aggressive treatment for seemingly unachievable goals? Conversely, how should physicians respond to parental requests for purely palliative care in situations where out- comes are not as bleak? Attendees will leave the session with a thorough understanding of the conflicting ethical obli- gations in perinatal decision-making, as well as an algorithm by which to evaluate parental re- quests for aggressive treatment or purely pallia- tive care. There will also be discussion of the role of conscientious refusal on the part of profes- sionals in situations where the parents’ request represents a fundamental violation of one’s own values. Speed Dating With Pharmacists: 50 Practical Medication Tips at End of Life (406) Kathryn Walker, PharmD BCPS CPE, University of Maryland School of Pharmacy, Baltimore, MD. Mary McPherson, PharmD BCPS CPE, University of Maryland School of Pharmacy, Baltimore, MD. Mina Kim, PharmD, University of Maryland School of Pharmacy, Baltimore, MD. (All authors listed above for this session have dis- closed no relevant financial relationships.) Objectives 1. Describe three medication tips related to dos- age formulations. 2. List three medications tips related to medica- tion administration. 3. List three medication tips related to stopping or starting medications. Complex medication decisions are an integral part of treating palliative care patients. Pharma- cists have a unique perspective on using these medications creatively and effectively. This one hour session will flirt with tips and tricks on using medications appropriately for patients facing ad- vanced diseases. Whether debriding a medication profile, aggressively treating symptoms, or strate- gizing a dosage formulation, it can be hard to com- mit to medication decisions. Three pharmacists will speed-date their way through 50 medication tips designed to highlight important and little known medication facts. Topics to be covered in- clude: when to taper maintenance medications, side effects such as hypogonadism with opioids, rectal administration of oral medications, using topical opioids, tips for maximizing dosing of patches, buccal versus transmucosal administra- tion, using opioid antagonists, anticholinergics and the blood brain barrier, medications that you can crush versus dissolve, value of nystatin for thrush, and 40 more! Find a tip that you are compatible with that may just change your life. SIG Symposia Using Pop Culture and Visual Arts in Palliative Care Education (407) Humanities SIG Lyra Sihra, MD, The Methodist Hospital, Hous- ton, TX. (Sihra has disclosed no relevant financial relationships.) 370 Vol. 43 No. 2 February 2012 Schedule With Abstracts

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Page 1: Speed Dating With Pharmacists: 50 Practical Medication Tips at End of Life (406)

370 Vol. 43 No. 2 February 2012Schedule With Abstracts

Objectives1. Identify diagnoses which are ethically appro-

priate for perinatal palliative care.2. Describe the limits of parental autonomy in

terms of requesting or refusing life-pro-longing treatment in the neonatal period.

3. Identify the role of conscientious refusal onthe part of professionals, especially with re-gard to palliative care of infants who mightsurvive.

The American Academy of Pediatrics ‘‘supportsan integrated model of palliative care in whichthe components of palliative care are offered atdiagnosis and continued throughout thecourse of illness.’’ A prenatal diagnosis ofa life-limiting condition therefore requires notonly care for the baby after birth but also ofthe mother and fetus during pregnancy anddelivery. This raises a host of ethical issues forthe obstetrical and pediatric teams, as theyweigh often-competing obligations to motherand fetus.This session will begin with an obstetrician anda pediatric palliative care consultant discussingthe obligation to accede to maternal requestfor caesarian section for a fetus with Trisomy13. The short- and long-term complications ofC-section are well-knowndand felt to be accept-able risks when the expected outcome isa healthy mother and a healthy neonatedbutdoes a mother’s wish for a baby born alive justifythese in the context of a lethal anomaly?Next a pediatric intensivist and ethicist will ex-plore the limits of parental autonomy in neonataldecision-making. The AAP specifies certainconditions (such as extreme prematurity, anen-cephaly, and Trisomy 13) as appropriate fornon-resuscitation in the delivery room, but whatif the family requests aggressive treatment forseemingly unachievable goals? Conversely, howshould physicians respond to parental requestsfor purely palliative care in situations where out-comes are not as bleak?Attendees will leave the session with a thoroughunderstanding of the conflicting ethical obli-gations in perinatal decision-making, as well asan algorithm by which to evaluate parental re-quests for aggressive treatment or purely pallia-tive care. There will also be discussion of therole of conscientious refusal on the part of profes-sionals in situations where the parents’ requestrepresents a fundamental violation of one’s ownvalues.

Speed Dating With Pharmacists:50 Practical Medication Tips at Endof Life (406)Kathryn Walker, PharmD BCPS CPE, Universityof Maryland School of Pharmacy, Baltimore, MD.Mary McPherson, PharmD BCPS CPE, Universityof Maryland School of Pharmacy, Baltimore, MD.Mina Kim, PharmD, University of MarylandSchool of Pharmacy, Baltimore, MD.(All authors listed above for this session have dis-closed no relevant financial relationships.)

Objectives1. Describe three medication tips related to dos-

age formulations.2. List three medications tips related to medica-

tion administration.3. List three medication tips related to stopping

or starting medications.Complex medication decisions are an integralpart of treating palliative care patients. Pharma-cists have a unique perspective on using thesemedications creatively and effectively. This onehour session will flirt with tips and tricks on usingmedications appropriately for patients facing ad-vanced diseases. Whether debriding a medicationprofile, aggressively treating symptoms, or strate-gizing adosage formulation, it canbehard to com-mit to medication decisions. Three pharmacistswill speed-date their way through 50 medicationtips designed to highlight important and littleknown medication facts. Topics to be covered in-clude: when to taper maintenance medications,side effects such as hypogonadism with opioids,rectal administration of oral medications, usingtopical opioids, tips for maximizing dosing ofpatches, buccal versus transmucosal administra-tion, using opioid antagonists, anticholinergicsand the blood brain barrier, medications thatyou can crush versus dissolve, value of nystatinfor thrush, and 40 more! Find a tip that you arecompatible with that may just change your life.

SIG Symposia

Using Pop Culture and Visual Arts inPalliative Care Education (407)Humanities SIGLyra Sihra, MD, The Methodist Hospital, Hous-ton, TX.(Sihra has disclosed no relevant financialrelationships.)