Fluent Essays

scroll through the attached paper. there are 6 case studies with very short questions to be answered in 1 sentence. there is also a self assessment split in 2 parts with a total of 35 single answer questions, and 3 very short and easy exercises.make sure you do all these and dont miss anything. Its an easy assignment Im going to upload the booklet that has the information in it and the questions that need to be answered. Its about pain medications and how to treat pain. new_york_medical_licensure_program.pdf Unformatted Attachment Preview CME FOR PHYSICIANS, PHYSICIAN ASSISTANTS, DENTISTS, PODIATRISTS, NURSES AND OTHER HEALTH CARE PROFESSIONALS 2020 NEW YORK MEDICAL LICENSURE PROGRAM TARGETED SERIES OF CME FOR LICENSE RENEWAL PROGRAM INCLUDES: 3 HOURS PAIN MANAGEMENT, PALLIATIVE CARE, & ADDICTION* 2 HOURS INFECTION CONTROL+ 5 TOTAL AMA PRA CATEGORY 1 CREDITSTM PROGRAM SATISFIES NEW YORK STATE MANDATORY TRAINING REQUIREMENTS: *3 HOURS MANDATORY PRESCRIBER EDUCATION FOR NEW YORK PRESCRIBERS +MANDATORY DEPARTMENT APPROVED INFECTION CONTROL TRAINING REQUIREMENT NY.CME.EDU InforMed is Accredited With Commendation by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. 2019 2020NEW NEWYORK YORK 01 OPIOID ANALGESICS IN THE MANAGEMENT OF ACUTE AND CHRONIC PAIN COURSE ONE | 3 CREDITS APPROVED TO SATISFY MANDATORY PRESCRIBER EDUCATION REQUIREMENT 47 INFECTION CONTROL IN HEALTHCARE SETTINGS COURSE TWO | 2 CREDITS APPROVED TO SATISFY MANDATORY INFECTION CONTROL TRAINING REQUIREMENT NEW YORK DOH APPROVED PROVIDER NUMBER: TP02082 73 SELF-ASSESSMENT & EVALUATION SURVEY REQUIRED TO RECEIVE CREDIT $50.00 PROGRAM PRICE ONLINE MAIL FAX NY.CME.EDU 1015 Atlantic Blvd #301 Jacksonville, FL 32233 1.800.647.1356 INFORMED TRACKS WHAT YOU NEED, WHEN YOU NEED IT New York State Department of Health MANDATORY PRESCRIBER EDUCATION Pursuant to Public Health Law (PHL) §3309-a(3), prescribers licensed under Title Eight of the Education Law in New York to treat humans and who have a DEA registration number to prescribe controlled substances, as well as medical residents who prescribe controlled substances under a facility DEA registration number, must complete at least three (3) hours of course work or training in pain management, palliative care, and addiction. MANDATORY INFECTION CONTROL TRAINING Pursuant to Public Health Law (PHL) § 239, every physician (MD/DO), physician assistant, specialist assistant, optometrist, podiatrist, dentist, dental hygienist, registered professional nurse, licensed practical nurse, medical student, medical resident, and physician assistant student practicing in the state of New York shall complete course work or training, appropriate to the professional’s practice, approved by the department regarding infection control. This requirement must be completed once every four (4) years. What This Means For You: New York prescribers with a DEA registration must complete at least three (3) hours of course work in pain management, palliative care, and addiction once every three (3) years within your applicable attestation period. See below for information on attestation timeline and process. Additionally, all physicians (MD/DO), PAs, specialist assistants, ODs, DPMs, DMD/DDS, RDH, RPNs, LPNs, medical students, medical residents, and PA students must complete approved course work or training appropriate to your professional practice in infection control. The infection control requirement must be met once every four (4) years. PRESCRIBER EDUCATION ATTESTATION DEADLINE Prescribers who attested to course completion PRIOR to 7/2/2017 must ATTEST to course completion by 6/30/2020. Prescribers who attested to course completion ON or AFTER 7/2/2017 have expiration dates three (3) years after your original attestation date To determine when your attestation period expires, prescribers must log into their HCS account and access their attestation history in the Narcotic Education Attestation Tracker (NEAT) application. For instructions on how to attest and log into your HCS account, visit https://www.health.ny.gov/professionals/narcotic/mandatory_prescriber_education/neat.htm LICENSE TYPES: PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS, DENTISTS, PODIATRISTS, OPTOMETRISTS & MEDICAL RESIDENTS Disclaimer: The above information is provided by InforMed and is intended to summarize state CE/CME license requirements for informational purposes only. This is not intended as a comprehensive statement of the law on this topic, nor to be relied upon as authoritative. All information should be verified independently. i For more than 45 years InforMed has been providing high-level education activities to physicians and other health care professionals. Through our level of engagement with a wide variety of stakeholders, including our physician association, we have become the foremost public health policy continuing medical education organization in the United States. We are recognized as the leading provider of mandatory CME activities to physicians as a means of updating knowledge, improving competencies and fulfilling requirements for federal, state, regulatory and license renewal New York Medical Professionals, InforMed is pleased to offer this collection of CME activities for health care practitioners licensed by the state of New York. The uniquely tailored curriculum is customized to meet the educational needs of New York medical professional. Participants earn AMA PRA Category 1 CreditTM through these self-directed, on-demand courses. This CME series is designed to streamline the education requirements of the New York Department of Health. Licensees who complete this program optimize their learning path while satisfying professional credentialing requirements for three (3) hours on controlled substances for prescribers, as well as fulfilling the infection control training requirement. All activities are independently sponsored by InforMed Continuing Medical Education without commercial support. Thank you for choosing InforMed as your CME provider. Please do not hesitate to contact us with any questions. -InforMed CME Team Visit NY.CME.EDU, select NETPASS to begin. NY.CME.EDU 1015 Atlantic Blvd #301 Jacksonville, FL 32233 ii OPIOID ANALGESICS IN THE MANAGEMENT OF ACUTE & Release Date: 09/2019 Exp. Date: 08/2022 3 AMA PRA Category 1 Credits™ Enduring Material (Self Study) CHRONIC PAIN TARGET AUDIENCE This course is designed for all physicians and health care providers involved in the treatment and monitoring of patients with pain. COURSE OBJECTIVE This course is designed to increase physician knowledge and skills regarding guideline-recommended principles of pain management, the range of opioid and non-opioid analgesic treatment options, and specific strategies for minimizing opioid analgesic prescription, diversion, and abuse. Read the course materials Complete the self-assessment questions at the end. A score of 70\% is required. Return your customer information/ answer sheet, evaluation, and payment to InforMed by mail, phone, fax or complete online at course website under NETPASS. LEARNING OBJECTIVES Completion of this course will better enable the course participant to: 1. Discuss the fundamental concepts of pain management, including pain types and mechanisms of action of major analgesics. 2. Identify the range of therapeutic options for managing acute and chronic pain, including non-pharmacologic approaches and pharmacologic (non-opioid and opioid analgesics) therapies. 3. Explain how to integrate opioid analgesics into a pain treatment plan individualized to the needs of the patient, including counseling patients and caregivers about the safe use of opioid analgesics. 4. Discuss recommendations for incorporating emergency opioid antagonists into prescribing practice, and for training patients and family members on the use of naloxone. 5. Recognize the risks of addiction inherent in the use of opioids for both acute and chronic pain and identify strategies to mitigate risks of diversion and misuse. 6. Identify medications currently approved for the treatment of opioid use disorder and the ways these medications differ in terms of mechanisms of action, regulatory requirements, and modes of administration. ACCREDITATION STATEMENT InforMed is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. DESIGNATION STATEMENT InforMed designates this enduring material for a maximum of 3 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 1 FACULTY Paul J. Christo, MD, MBA Director, Multidisciplinary Pain Fellowship Program Associate Professor of Anesthesiology and Critical Care Medicine The Johns Hopkins University School of Medicine Melissa B. Weimer, DO, MCR, FASAM Assistant Professor Department of Internal Medicine Yale University School of Medicine 3 Pain Management, Palliative Care and Addiction Stephen Braun Medical Writer Braun Medical Communications 3 HOURS MANDATORY PRESCRIBER EDUCATION NEW YORK SPECIAL DESIGNATON New York prescribers who complete this course, fulfill the mandatory prescriber education requirements set forth in PHL § 3309-a(3) for 3 hours in pain management, palliative care, and addiction. ACTIVITY PLANNER Per the criteria established by the NYS Department of Health and outlined in the Mandatory Prescriber Education Guidance, this course is valid for ALL New York prescribers required to complete the mandatory education. Michael Brooks Director of CME, InforMed DISCLOSURE OF INTEREST In accordance with the ACCME Standards for Commercial Support of CME, InforMed implemented mechanisms, prior to the planning and implementation of this CME activity, to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity. Prescribers licensed under Title Eight of the Education Law in New York to treat humans and who have a DEA registration number to prescribe controlled substances must complete at least three (3) hours of course work or training in pain management, palliative care, and addiction. Medical residents who prescribe controlled substances under a facility DEA registration number must also complete course work or training. FACULTY/PLANNING COMMITTEE DISCLOSURE The following faculty and/or planning committee members have indicated they have no relationship(s) with industry to disclose relative to the content of this CME activity: • Stephen Braun • Michael Brooks The following faculty and/or planning committee members have indicated that they have relationship(s) with industry to disclose: • Paul J. Christo, MD, MBA has received honoraria from GlaxoSmithKline, Daiichi Sankyo, and BTG International. • Melissa B. Weimer, DO, MCR, FASAM has received honoraria from Alkermes STAFF AND CONTENT REVIEWERS InforMed staff, input committee and all content validation reviewers involved with this activity have reported no relevant financial relationships with commercial interests. DISCLAIMER *2020. All rights reserved. These materials, except those in the public domain, may not be reproduced without permission from InforMed. This publication is designed to provide general information prepared by professionals in regard to the subject matter covered. It is provided with the understanding that InforMed, Inc is not engaged in rendering legal, medical or other professional services. Although prepared by professionals, this publication should not be utilized as a substitute for professional services in specific situations. If legal advice, medical advice or other expert assistance is required, the service of a professional should be sought. 2 The challenge of pain management The experience of pain has been long-recognized as a national public health problem with profound physical, emotional, and societal costs.1 Although estimates vary depending on the methodology used to assess pain, chronic pain is estimated to affect 50 million U.S. adults, and 19.6 million of those adults experience high-impact chronic pain that interferes with daily life or work activities.2 The cost of pain in the United States is estimated at between $560 billion and $635 billion annually.3 Primary care physicians, pain specialists, and other healthcare providers have been working to improve care for those suffering from acute and chronic pain in an era challenged by the opioid crisis. The United States has seen three successive waves of opioid overdose deaths related to both legal and illegal opioids (Figure 1).4 The first began in the 1990s and was associated with steadily rising rates of prescription opioids. In 2010, deaths from heroin increased sharply, and by 2011 opioid overdose deaths reached “epidemic” levels as described by the Centers for Disease Control and Prevention (CDC).5 The third wave began in 2013 with a sharp rise in overdose deaths attributed to synthetic opioids, particularly those involving illicitly-manufactured fentanyl. By 2017 (the latest year for which data are available) an average of 130 people were dying every day from opioidrelated overdoses.6 Between 1999 and 2017, the CDC estimates that nearly 400,000 people in the United States died from such overdoses.7 Coupled with rising rates of overdose death are equally dramatic increases in the number of people misusing or abusing opioids. As many as 1 in 4 patients on long-term opioid therapy in a primary care setting are estimated to be struggling with opioid use disorder (OUD), also called opioid addiction.8-10 In 2016 approximately 11.5 million Americans reported misusing prescription opioids in the previous year.11 Although the rates of opioid prescriptions have leveled off or declined slightly in recent years, the average days of supply per opioid prescription has continued to rise (Figure 2). Between 2006 and 2016, average days of supply per prescription increased from 13.3 days to 18.3 days, an overall relative increase of 37.6\%.11 Figure 1. Opioid-related overdose deaths by type in the United States7 Figure 2. Average days of supply per opioid prescription in the U.S., 2006-201711 Key opioid-related terms Opioid: any psychoactive chemical resembling morphine, including opiates, and binding to opioid receptors in the brain. This term describes opioid and opiates. Opiate: “natural” opioids derived from the opium poppy (e.g., opium, morphine, heroin). Semi-synthetic opioids: analgesics containing both natural and manufactured compounds (e.g., oxycodone, hydrocodone, hydromorphone, oxymorphone). Synthetic opioids: fully-human-made compounds (e.g., methadone, tramadol, and fentanyl). The surge in opioid prescribing affects patients of all ages, including the elderly. Nearly one in three Medicare beneficiaries received a prescription for oxycodone ER, hydrocodone-acetaminophen, oxycodone-acetaminophen, or fentanyl in 2016.12 Medicare spending under Part D for these opioid pain medications has grown substantially as well, exceeding $4 billion in 2015.12 It is against this background that providers must make daily decisions about how best to treat their patients in pain. Unfortunately, many providers are unfamiliar with the growing evidence base suggesting that opioids are actually not very effective for relieving chronic non-cancer pain in the long-term and, in fact, may be associated with harms such as increased pain, reduced functioning, and physical opioid dependence.13,14 Providers may also not be aware of the expanding range of both non-opioid medications and non-pharmacological therapies shown to be effective in reducing many common chronic pain conditions. This CME learning activity discusses the management of chronic and acute pain in a variety of patient populations and is structured to conform to the Food and Drug Administration’s (FDA’s) 2018 Blueprint for Health Care Providers Involved in the Treatment and Monitoring of Patients with Pain. It reviews evidence for non-opioid therapies, including non-drug and non-opioid drug options, as well as current evidence regarding opioid efficacy, harms, and overdose prevention with naloxone, and how to slowly and safely taper opioid doses. The nature of pain As unpleasant as it is, acute pain serves an important adaptive biological purpose: it alerts people to internal or external bodily damage or dysfunction. Acute pain can provoke a range of protective reflexes (e.g., withdrawal of a damaged limb, muscle spasm, autonomic responses) that can prevent further damage and help the body heal. Even brief episodes of acute pain, however, can induce suffering, neuronal remodeling, and can set the stage for chronic pain.15 3 Pain can be classified on the basis of its pathophysiology. Nociceptive pain is caused by the activation of nociceptors (pain receptors), and is generally, though not always, short-lived, and associated with the presence of an underlying medical condition. This is “normal” acute pain: a physiological response to an injurious stimulus. Neuropathic pain, on the other hand, results from an injury to the peripheral or central nervous system. It is an abnormal response to a stimulus caused by dysfunctional neuronal firing in the absence of active tissue damage. It may be continuous or episodic and varies widely in how it is perceived. Neuropathic pain is complex and can be difficult to diagnose. Related to both nociceptive and neuropathic pain is the phenomenon of sensitization, which is a state of hyperexcitability in either peripheral nociceptors or neurons in the central nervous system (i.e., central sensitization). Sensitization may lead to either hyperalgesia (heightened pain from a stimulus that normally provokes pain) or allodynia (pain from a stimulus that is not normally painful).16 Sensitization may arise from intense, repeated, or prolonged stimulation and subsequent upregulation of nociceptors, from the influence of compounds released by the body in response to tissue damage or inflammation, or sometimes as an adaptation to prolonged exposure to opioid analgesics.17 Many patients—particularly those with chronic pain—experience pain with both nociceptive and neuropathic components, which complicates assessment and treatment. Differentiating between nociceptive and neuropathic pain is critical because the two respond differently to pain treatments. Neuropathic pain, for example, may respond poorly to both opioid analgesics and non-steroidal anti-inflammatory (NSAID) agents.18 Other classes of medications, such as anti-epileptics, antidepressants, or local anesthetics, may provide more effective relief for neuropathic pain.19 Another important dimension of pain is its effects beyond strictly physiological functioning. Pain is currently viewed as a multi-dimensional, multi-level process similar in many ways to other disease processes which may start with a specific injury but which can lead to a cascade of events that can include physical deconditioning, psychological and emotional burdens, and dysfunctional behavior patterns that affect not just the sufferer, but their entire social milieu (illustrated in Figure 3).1 The pain community is currently discussing an expansion of the current definition of pain to include a biopsychosocial perspective: “pain is a distressing experience associated with actual or potential tissue damage with sensory, emotional, cognitive, and social components.”20 Acute pain is defined as having an abrupt onset and is typically due to an obvious 4 Figure 3. The biopsychosocial model of pain1 cause, such as an injury or surgical procedure. It has a generally short duration, and usually lasts less than four weeks, improving with time.15 Acute pain is one of the most common presenting complaints in ambulatory care.21 In contrast, chronic pain is defined as lasting more than three months or past the time of normal tissue healing. It can result from an underlying medical disease or condition, injury, medical treatment, inflammation, or an unknown cause.22 Although pain is expected after injury or surgery, the patient pain experience can vary markedly. The intensity of pain can be influenced by psychological distress (e.g., depression or anxiety), heightened illness concern, or ineffective coping strategies regarding the ... Purchase answer to see full attachment