Pharmacotherapy in the Complex Patient With Shift Work Disorder
Jointly provided by
Support for this activity has been made possible through an educational grant from Teva Pharmaceuticals.
Release date: 9/30/2014
Expiration date: 9/30/2015
Estimated time to complete: 30 minutes
Shift work disorder (SWD) is a formally recognized sleep disorder that occurs in people who work nontraditional hours (ie, outside of the standard 9 am–5 pm schedule). A number of symptoms are indicative of SWD, but the most common are excessive sleepiness and insomnia. Although several nonpharmacologic and pharmacologic therapies can be used to effectively manage the symptoms of SWD, many people with the condition remain undiagnosed and untreated. This Virtual Practice, which includes a for-credit scientific presentation and three for-credit case studies, has been developed to improve the general understanding of the diagnosis and management of SWD. In addition, the Virtual Practice features several valuable tools that can be used in clinical practice to improve the management of SWD.
In this module, Dr. Stevens reviews the use of pharmacotherapy in a complex case: a patient with SWD who also has several comorbidities.
Paul P. Doghramji, MD, FAAFP—Program Chair
Pottstown Memorial Medical Center
Medical Director, Health Services
Karl Doghramji, MD
Professor of Psychiatry, Neurology, and Medicine
Medical Director, Jefferson Sleep Disorders Center
Program Director, Fellowship in Sleep Medicine
Thomas Jefferson University
Jacqueline Valdez-Bedikian, PharmD
Western Drug Pharmacy
Teresa D. Valerio, DNP, APN, FNP-BC, CBSM
Doctor of Nursing Practice Program Leader
Mennonite College of Nursing
Illinois State University
This activity has been designed to meet the educational needs of primary care physicians, nurse practitioners, physician assistants, pharmacists, nurses, and other health care professionals who are involved in the management of patients who have or are at risk for SWD.
After participating in the activity, learners should be better able to:
- Implement treatment strategies that utilize pharmacologic modalities to alleviate symptoms of SWD
Accreditation and Credit Designation
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Academy of CME, Inc., and RedMedEd. The American Academy of CME, Inc., is accredited by the ACCME to provide continuing medical education for physicians.
American Academy of CME, Inc., designates this enduring material for a maximum of 0.5AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
American Academy of CME, Inc., is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
American Academy of CME, Inc., designates this educational activity for 0.5 contact hours.
The American Academy of CME, Inc., is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.
This activity provides 0.5 contact hours (0.05 CEUs) of continuing education credit. ACPE Universal Activity Number 0297-9999-14-022-H01-P, Knowledge.
According to the disclosure policy of American Academy of CME, Inc., all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relevant relationships with any commercial interests related to this activity. The existence of these interests or relationships is not viewed as implying bias or decreasing the value of the presentation. All educational materials are reviewed for fair balance, scientific objectivity and levels of evidence. Disclosures are as follows:
Jacqueline Valdez-Bedikian, PharmD, has disclosed no relevant financial relationships with any commercial interests.
Karl Doghramji, MD, has disclosed the following relevant financial relationships:
Consultant: Aptalis, Jazz, Vanda, UCB, Teva Pharmaceuticals
Shareholder: Merck (self and spouse/partner)
Other: Contributor to the Merck Manual and the Merck Manual Home Health Handbook
Paul P. Doghramji, MD, FAAFP, has disclosed the following relevant financial relationships:
Advisory Board: AstraZeneca, Horizon, Merck, Teva Pharmaceuticals
Speakers Bureau: Horizon, Takeda, Teva Pharmaceuticals
Teresa D. Valerio, DNP, APN, FNP-BC, CBSM, has reported no relevant financial relationships with any commercial interests.
Independent Clinical Peer Reviewer
Bennett S. Shenker, MD, MS, MSPH, FAAFP, Assistant Professor of Family Medicine, Rutgers, The State University of New Jersey, Rutgers Robert Wood Johnson Medical School, Rutgers RWJ Family Medicine Residency at CentraState, Freehold, NJ, has reported the following financial relationship: Board of Managers Central New Jersey Accountable Care Organization
John JD Juchniewicz, MCIS, CCMEP, and Natalie Kirkwood, RN, BSN, JD, Lead Nurse Planner, American Academy of CME, Inc., have disclosed no relevant financial relationships with any commercial interests.
Thomas Finnegan, PhD, and Jonathan S. Simmons, ELS, RedMedEd, have reported no relevant financial relationships with any commercial interests.
Robert Gengerke, RedMedEd, has reported the following relevant financial relationships: Freelance writer (sales training and marketing materials): GlaxoSmithKline, Ikaria, Novartis, Gilead Sciences, Forest, Ironwood, Genzyme, Daiichi-Sankyo, Bayer, Noven, Johnson & Johnson.
This activity will discuss off-label or investigational information.
|Generic Name||Trade Name||Approved Use (if any)|| Unapproved/ |
|Doxepin||Prudoxin, Silenor, Zonalon|| ||Insomnia in patients with SWD|
|Estazolam||none|| ||Insomnia in patients with SWD|
|Eszopiclone||Lunesta|| ||Insomnia in patients with SWD|
|Flurazepam||Dalmane, Dalmadorm|| ||Insomnia in patients with SWD|
|Methamphetamine||Desoxyn|| ||Excessive sleepiness in patients with SWD|
|Ramelteon||Rozerem|| ||Insomnia in patients with SWD|
|Temazepam||Restoril, Strazepam|| ||Insomnia in patients with SWD|
|Triazolam||Halcion|| ||Insomnia in patients with SWD|
|Quazepam||Doral|| ||Insomnia in patients with SWD|
|Zolpidem||Ambien, Ambien CR, Edluar, Intermezzo|| ||Insomnia in patients with SWD|
The opinions expressed in this educational activity are those of the faculty and do not represent those of American Academy of CME, Inc., RedMedEd, or the American Nurses Credentialing Center’s Commission on Accreditation. This activity is intended to supplement existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically and draw conclusions only after careful consideration of all available scientific information.
Method of Participation
There are no fees to participate in the activity. Participants must review all activity information, including the learning objectives, disclosure statements, and content. To receive CME/CNE/CPE credit for participation, participants must complete the posttest (achieving a passing grade of 70% or greater) and program evaluation. Certificates can be printed immediately. For pharmacists, a statement of credit will be issued through CPE Monitor in 6–8 weeks.
- Apple iPad or iPad mini (iOS 7 or higher) with an Internet connection
- A computer with an Internet connection
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- Additional software: Adobe Flash Player and/or an HTML 5-capable browser is required for video or audio playback; Adobe Acrobat Reader may occasionally be required
For any questions, please contact CEServices@academycme.org.
© 2014. This CME/CNE/CPE-certified program is held as copyrighted by American Academy of CME, Inc., and RedMedEd. Through this notice, the American Academy of CME, Inc., and RedMedEd grant permission of its use for educational purposes only. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owners.