Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Lost in Translation: Making Sense of Clinical Treatment Guidelines
UAN 0530-0000-18-040-L01-P
AANP Rx Hours 0.0
Course Description
Multiple clinical treatment guidelines have been published regarding headache and pain management. However, many have questioned the benefit of such clinical guidelines for the treatment of individual patients. This course will review key published treatment guidelines for migraine, interventional pain management, chronic opioid use, neuropathic pain, and chronic low back pain. The faculty will review the relevant guidelines and discuss their strengths and critical weaknesses when using such guidelines to actually treat people.
Charles E. Argoff, MD, CPE
8:30a - 9:30a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by PERNIX Therapeutics, Scott Fowler, PA-C
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - The Role of Advanced Practice Providers in Acute Pain Management
UAN 0530-0000-18-331-L01-P
AANP Rx Hours 0.1
Course Description
Millions of patients each year suffer from acute pain as a result of trauma, illness, or surgery. Pain is the most common reason for admission to the emergency department (ED), comprising more than 40% of the over 100 million ED visits annually. The prevalence of intense acute pain is similarly high among patients undergoing surgery: in the United States, over 73 million surgical procedures are performed annually, and most patients report experiencing a high degree of pain postoperatively. Studies indicate that treatment of acute pain remains suboptimal due to attitudes and educational barriers on the part of clinicians and patients, as well as the intrinsic limitations of available therapies. Inadequate management of acute pain negatively impacts numerous aspects of patient health and may increase the risk of developing chronic pain. This presentation will review the differences between acute and chronic or persistent pain, while providing attendees with a multimodal treatment approach for the acute care setting. Emphasis will be placed on the role of the advanced practice provider.
Theresa Mallick-Searle, MS, NP-BC, ANP-BC
10:40a - 11:40a - Mirror, Mirror on the Wall: Graded Motor Imagery to Treat Complex Regional Pain Syndromes
UAN 0530-0000-18-326-L01-P
AANP Rx Hours 0.1
Course Description
Complex regional pain syndrome (CRPS) is a painful condition localized to a limb or body region, typically in response to trauma or surgery. Although several contributing mechanisms of CRPS have been described, the exact pathophysiology of the condition is not completely known. Graded motor imagery (GMI) is a comprehensive program aimed at sequentially activating motor cortical networks of the disordered limb to improve neural reorganization. GMI includes phases of progressive sensory-motor restructuring beginning with laterality training, guided imagery, and ultimately leading to mirror therapy. In this lecture, leading mechanisms for the development of CRPS will be discussed, along with the role of reorganization of the somatosensory cortex. In addition, treatment algorithms will be included along with medications, injections, and a thorough review of GMI and its outcomes.
Michael M. Bottros, MD
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break & Exhibits
12:10p - 1:10p - Product, Disease Awareness, Medical Information Program*
Lunch will be served.
Sponsored by Salix Pharmaceuticals, Eugene Viscusi, MD
1:10p - 2:00p - Rational Polypharmacy: An Update for Specific Conditions
UAN 0530-0000-18-048-L01-P
AANP Rx Hours 0.0
Course Description
Multiple clinical treatment guidelines have been published regarding headache and pain management. However, many have questioned the benefit of such clinical guidelines for the treatment of individual patients. This course will review key published treatment guidelines for migraine, interventional pain management, chronic opioid use, neuropathic pain, and chronic low back pain. The faculty will review the relevant guidelines and discuss their strengths and critical weaknesses when using such guidelines to actually treat people.
Charles E. Argoff, MD, CPE
2:00p - 2:10p - Break & Exhibits
2:10p - 3:00p - Product, Disease Awareness, Medical Information Program*
Refreshments will be served.
Sponsored by SCILEX Pharmaceuticals, Christopher Gharibo, MD
3:00p - 3:50p - Medical Cannabis: Focus on Pain Management
UAN 0530-0000-18-061-L01-P
AANP Rx Hours 0.0
Course Description
The endocannabinoid system (ECS) is recognized as an important modulator of many physiological processes. Recently, an increasing body of evidence has been accumulated to suggest the antioxidant, anti-inflammatory, neuroprotective, and antinociceptive roles of the ECS. In 1997, the Office of National Drug Control Policy commissioned the Institute of Medicine (IOM) to conduct a comprehensive study of the medical efficacy of cannabis therapeutics. The IOM concluded that cannabis is a safe and effective medicine, patients should have access, and the government should expand avenues for research and drug development. This course will discuss cannabis as it relates to effective pain management.
Theresa Mallick-Searle, MS, NP-BC, ANP-BC
3:50p - 4:40p - How Central is Central Poststroke Pain?
UAN 0530-0000-18-325-L01-P
AANP Rx Hours 0.2
Course Description
Central poststroke pain (CPSP) is a neuropathic pain disorder frequently described as burning pain associated with allodynia and hyperalgesia over affected regions of the body. The underlying mechanisms are not well understood. It has been suggested that stroke associated loss of inhibitory neurons in the spinothalamic tract causes disinhibition of thalamic neurons, which generate ectopic nociceptive action potentials responsible for the pain experience. However, recent data suggests that pain is dependent on the peripheral afferent input and may be mediated by misinterpretation of sensory input. In this course, we review the pathophysiology, clinical presentation, and symptoms of CPSP. Recent findings may also shed light about future targets for treatment.
Michael M. Bottros, MD
*Not certified for credit.
Schedule (subject to change)
7:00a - 7:30a - Registration and Exhibits
Coffee will be served.
7:30a - 8:30a - Year of the Locusts: The CDC Guidelines Impact on Practitioners and Patients
UAN 0530-0000-18-072-L01-P
AANP Rx Hours 0.0
Course Description
The CDC guidelines have caused controversy and spurred heated discussion. Produced with a paucity of evidence based medicine, they were never evaluated and iterated in the manner of more appropriate guidelines. In this course, we will examine the guidelines and their effect on practitioners--primary care physicians, pain specialists, etc--and chronic pain noncancer patients as well as some chronic cancer patients. Many functioning patients have had their opioid dosages diminished, either in concert with their physician or forcibly, without any say in the matter. This, along with a marked reduction in the amount of legal opioid medications that can be produced, has led to significant unintended consequences: practitioners are leaving the field; some refuse to even prescribe opioids, mostly due to fear of overregulation; once-functional patients are being abandoned by the medical field; patients are searching for something to return them to functionality, which can lead to overdose and death, particularly from heroin and illicit fentanyl. Indeed, the opioid crisis has now become the heroin and fentanyl crisis. During this presentation, solutions, and the changes necessary to bring them about, will be discussed.
Gary W. Jay, MD, FAAPM, FACFEI
8:30a - 9:30a - 3's Company: COX-2 Inhibitors, Medicinal Marijuana, and Opioid Prescribing
UAN 0530-0000-18-031-L01-P
AANP Rx Hours 0.0
Course Description
There is much controversy around many aspects of pain treatment, and compelling arguments have focused on both sides of the fence regarding appropriate opioid use and prescribing, legalization of marijuana, and the safety of cox-2 inhibitors. In all 3 cases, there are issues associated with strong positions, although the evidence, when put into practice, is less black and white. For each topic, we will evaluate current literature and debate the clinical, legal, and ethical controversies surrounding recent developments in pain management. Attendees will get a better understanding as presenters debate evidence based application of the cdc guidelines in various clinical settings, evaluate clinical and ethical concerns regarding marijuana for medicinal or recreational use, and take a critical look at the literature and its application when using cox-2 inhibitors for treating pain.
Alexandra McPherson, PharmD, MPH
9:30a - 9:40a - Break & Exhibits
9:40a - 10:40a - Product, Disease Awareness, Medical Information Program*
Breakfast will be served.
Sponsored by Teva Pharmaceutical. Vincent T. Martin, MD, FAHS
10:40a - 11:40a - The Dynamics of Managing Acute Postoperative Pain in the Current Opioid Sparing Environment
UAN 0530-0000-18-327-L01-P
AANP Rx Hours 0.1
Course Description
Considering the significant risks of surgery, initiatives to improve safety and outcomes would have a broad impact on public health. The number of surgical procedures worldwide has grown to over 232 million annually. Studies report that Americans undergo an average of 9.2 surgical procedures per lifetime: 3.4 inpatient, 2.6 outpatient, and 3.2 nonoperating room invasive procedures. The per capita rate of surgery continues to increase through age 75, peaking at 0.16 operations per person per year. Acute pain is a consequence of most surgical interventions. Certain procedures result in higher pain trajectories that, if not adequately addressed, can lead to poorer outcomes and increased costs. Clinical pathways are being developed to address improving outcomes in the most cost-efficient manners. This program examines new options on the horizon for the management of moderate to severe in-hospital acute pain management; the impact of scheduled vs not scheduled analgesics related to the management of in-hospital acute postoperative pain management; health economic and outcomes measures related to in-hospital acute moderate to severe postoperative pain; and enhanced recovery after surgery.
Robert L. Barkin, MBA, PharmD, FCP, DAPM
11:40a - 12:00p - Faculty Q&A
12:00p - 12:10p - Break & Exhibits
12:10p - 1:10p - Migraines A-Z
UAN 0530-0000-18-070-L01-P
AANP Rx Hours 0.2
During this course, we will go over the clinical symptomatology of migraine in a number of its various forms, as well as the pathophysiology of migraine. We will go over the acute as well as prophylactic treatment of migraine using evidence based criteria.
Gary W. Jay, MD, FAAPM, FACFEI
1:10p - 2:00p - The 411 on Nonprescription Analgesics: When to Hold 'Em, When to Fold 'Em
UAN 0530-0000-18-052-L01-P
AANP Rx Hours 0.7
Course Description
Pain is the number one reason why patients seek advice from their pharmacist or primary care provider. Patients very often seek to use a nonprescription analgesic to self-treat a painful complaint, yet often do not understand the exclusions to selftreatment or how to select the best analgesic. Participants in this presentation will learn what nonprescription analgesics are available, indications for use, appropriate dosing and duration of therapy, appropriateness of candidates, and how to monitor and educate patients about their nonprescription analgesic. At this presentation, participants will learn the mechanism of action, indications, adverse effects, and precautions of oral and topical nonprescription analgesics, along with patient counseling points when recommending a nonprescription analgesic.
Alexandra McPherson, PharmD
2:00p - 2:50p - The Right Drug, the Right Patient, the Right Time
UAN 0530-0000-18-328-L01-P
AANP Rx Hours 0.6
Course Description
The content of this presentation will encourage audience participation. The "rights" section--drug, patient, time--will enable participants to reflect on medical malpractice cases where these rights were initiated in less than adequate outcomes and fell below the standard of care. Additionally, attendees will come to understand the pharmacokinetic challenges often reflected in the treatment of the geriatric patient, and there will be discussion of the various opioid metabolism routes of substrate, inducer, and inhibitor pathways.
Robert L. Barkin, MBA, PharmD, FCP, DAPM
*Not certified for credit.
