Pain Management and Palliative Care for Clinical Pharmacists CP 162 Mark Holtsman, Pharm.D.

 Learn what made these students want to dance with their Professor!  Classes meet on Tuesday afternoons this fall from 5 - 7 PM  Live Dates: 09/27/16, 10/04/16, 10/11/16, 10/25/16, 11/08/16 and 11/15/16  Teleconference dates will be on above dates if needed  Guest lectures from John MacMillan, M.D., Pouria Kashkouli, M.D., and Charity Hale, Pharm.D. , UC Davis Hospice and Palliative Care Service

The goal of this course is to help students understand clinical issues faced by patients seeking palliative care. The objectives of this course are to discuss optimal pharmacotherapy management for pain and symptoms including nausea, vomiting, sedation, constipation, insomnia, delirium, anxiety and itching. Students will learn how to design medication regimens taking comorbidities, patient defined goals, and new pharmacotherapy developments into consideration. Feedback from the class of 2015 was used to revise curriculum to further enhance critical thinking and problem solving skills as students learn how to work as part of an interdisciplinary team while working through patient cases. The teams consist of pharmacy, nursing, and medical students. The following areas are covered:

Introduction to a Pharmacist’s Role in Palliative Care Discuss differences between palliative care and hospice, goals of care, and types of illnesses seen in palliative care patients. Students will learn how to emulate the role of a pharmacist while optimizing pharmacotherapy through discussions and case studies.

Pain Management in Palliative Care Review pain terminology, pain assessment skills, pain mechanisms, and common pain etiologies for patients receiving palliative care. Case studies will be utilized to illustrate a pain mechanism and a pharmacist’s role in suggesting pharmacotherapy. Review opioid analgesic pharmacotherapy, equianalgesic opioid conversions, and a pharmacist’s role in selecting patients appropriate for opioid rotation as well as calculating correct opioid equianalgesic doses. This lecture will also use case studies to review concepts in developing breakthrough pain regimens.

Symptom Management in Palliative Care Review common side effects experienced by patients utilizing opioid analgesics, corticosteroids, anticonvulsants, antidepressants, benzodiazepines and muscle relaxants. Common symptoms which cause distress and suffering in palliative care patients will be described. Case studies will be utilized to illustrate a pharmacist’s role in suggesting pharmacotherapy to minimize side effects and manage distressing symptoms. Describe management of especially challenging patients in palliative care including patients with delirium, severe renal dysfunction, severe nausea and vomiting, myoclonus, and significant sedation. Explain Aid in Dying legal requirements and responsibilities. Case studies will be used to illustrate the pharmacist’s role in suggesting pharmacotherapy to manage pain and symptoms.