Carol Motycka

A review of the treatment of type 2 diabetes in children.

The incidence of type 2 diabetes and obesity in children and adolescents has risen at staggering rates. Studies have shown that treating type 2 diabetes with oral medications in children may be more difficult than treating in adults. Compounding this problem is the fact that most of the medications available for treating type 2 diabetes have not been studied in children. Recently, the American Diabetes Association and the Pediatric Endocrine Society have collaborated to create a guideline for the treatment of type 2 diabetes in children. Similar to the treatment of adults with type 2 diabetes, metformin remains the mainstay of therapy along with diet and exercise. Adjunctive therapy should be based on the limited clinical evidence available as well as on patient preference. In order to avoid detrimental microvascular and macrovascular complications, patients, clinicians, and family members should work together to ensure adequate treatment of type 2 diabetes in children.

Redesign of a Pediatric Pharmacotherapy Elective Course to Accommodate Budget Reductions

Objective. To redesign a pediatric elective pharmacotherapy course and determine whether the redesign resulted in changes in outcome measures. Design. Active learning activities were moved to an online format. Prerecorded lectures continued to be used. Peer evaluation was incorporated to give the students more feedback on their performance. Assessment. Presentation grades, average examination grades, course grades, and evaluation scores from each student who completed University course evaluations were documented for students during the 2 semesters before and the 2 semesters after the course redesign. Although for undetermined reasons a drop in examination grades occurred after the course redesign, no significant differences in presentation grades, final grades, or course evaluation grades occurred. Conclusions. A strategic course redesign successfully reduced the costs and faculty time required to offer an elective course viewed as essential to the curriculum, allowing the course to be continued in the face of state budget cuts.

Teaching End-of-Life Care Using Interprofessional Simulation

BACKGROUND Competency in end-of-life (EOL) care is a growing expectation for health professions students. This study assessed the impact of four EOL care scenarios, using high-fidelity simulation, on the perceived learning needs and attitudes of pharmacy and nursing students. METHOD On three campuses, pharmacy students (N = 158) were exposed to standard paper EOL case scenarios, while a fourth campus exposed eight graduate nursing and 37 graduate pharmacy students to simulated versions of the same cases. RESULTS The paper-based groups produced similar pre-post changes on the End of Life Professional Caregiver Survey. Results were pooled and compared with the simulation-only group, revealing significantly higher changes in pre-post scores for the simulation group. CONCLUSION Students participating in the simulation group showed some significant differences in attitudes toward EOL care, compared with students in the classroom setting. [J Nurs Educ. 2017;56(4):205-210.].

Using interprofessional medication management simulations to impact student attitudes toward teamwork to prevent medication errors

BACKGROUND We developed and implemented a project incorporating ACPE Standard 11 and all Core IPEC competencies at a public University located at a medical center. The project was a collaboration between the colleges of nursing, pharmacy, and medicine at a distance campus location. INTERPROFESSIONAL EDUCATION ACTIVITY Our Interprofessional Education Activity, which targeted all three elements of ACPE Standard 11, provided TeamSTEPPS® training followed by four medical error simulations. A debriefing took place after each scenario within a team as well as with all four groups following each simulation session. The Teamwork Attitudes Questionnaire (TTAQ) was used to evaluate the activity. DISCUSSION Findings from our interprofessional education activity indicate that while students entered the activity already perceiving teamwork as a positive aspect of safe care delivery, significant improvement in attitudes post training toward specific team constructs was seen across all five domains. The project helped inform the structure of a replication of this effort that is currently underway, with a focus on embedding it in the curricula of all three programs (medicine, pharmacy, and nursing) across campuses. IMPLICATIONS In summary, working collaboratively in a team while being exposed to a series of medication management scenarios enhances teamwork attitudes as well as potentially improving performance. Based on the positive initial results, plans have begun to extend the experience to other campuses and include a wider group of students.

The Impact of Medical Marijuana on Pharmacy Practice

Objective: As health care providers, it is important to recognize the potential health issues associated with marijuana use and to educate patients appropriately. As with other types of medication, marijuana has drug interactions, side effects, and the potential for toxicity. In addition, as with other substances that are abused, marijuana has the potential for dependence and addiction. The expanding use of marijuana will increase the pharmacists involvement with marijuana as part of a patients regimen. The objective of this paper is to educate health care providers on potential counseling points for patients in regards to side effects, drug interactions and other potential adverse effects from marijuana use. Summary: Currently in the United States, 29 states (plus Washington D.C.) have passed laws allowing for the use of medical marijuana. The possession limit and form of marijuana varies by state. It is imperative that pharmacists understand the laws in their state and the overall effects of marijuana. Conclusion: The increased legalization will continue to expand marijuanas use among patients, necessitating health care providers to be well informed regarding marijuanas side effects, drug interactions, and addiction potential.

Side Effects and Drug Interactions of Marijuana

The use of marijuana as a medication continues to be debated around the United States with legalization being discussed in several states. Understanding the adverse effects and drug interactions of marijuana are important as more people look to using this substance as a form of treatment. Marijuana has been associated with several adverse effects when used both short term and long term. It is also a substance which may interact with commonly used medications. This article will discuss some of the commonly known adverse effects and interactions.

Type 2 Diabetes in Children: A Growing Epidemic

In the pediatric population, type 2 diabetes has become a growing concern. A correlation appears to exist among type 2 diabetes in children, obesity, and a sedentary lifestyle. If obesity and diabetes are left untreated, conditions such as cardiovascular disease, nephropathy, and retinopathy may result as well. These conditions indicate the incredible strain on the health care system caused by diabetes and obesity. This strain may be eased by logical treatments such as exercise and healthy eating habits for the child and family. However, these lifestyle changes are not always effective in controlling blood sugar. When lifestyle changes do not yield positive results, the clinician must decide which (if any) pharmacological treatments are safe to use in the pediatric population. Orlistat and sibutramine have been studied in children as treatments for obesity and appear to be safe and effective for this population. Metformin and insulin are among the medications approved to treat diabetes in children and adolescents. Healthcare practitioners must play a role in educating parents and their children about the effects of obesity on the development of diseases like diabetes, as well as various therapies used to manage diabetes. In addition, healthcare practitioners can assist patients and their parents in understanding the benefits and risks of medications used in the treatment of the disease, assistance that may result in them making informed decisions regarding their overall health.