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Aim A case of an 85-year-old patient with concurrent use of warfarin and medical cannabis containing delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) is described. Warfarin continues to be a cornerstone of anticoagulation treatment despite the recent addition of FDA-approved anticoagulant agents. It is well known that warfarin has numerous drug interactions; however, much remains unknown about its interaction with THC and CBD. A literature review was conducted to identify documented cases of possible interactions between cannabis and warfarin. The case reports we identified noted that cannabis may potentially increase warfarin’s effect. Therefore, we aimed to determine why an effect was not seen on our patient’s warfarin dose despite daily use of medical cannabis. Case This case report describes an 85-year-old patient who despite starting an oromucosal medical cannabis regimen of THC and CBD (which provided 0.3 mg of THC and 5.3 mg CBD once daily and an additional 0.625 mg of THC and 0.625 mg CBD once daily as needed) had minimal INR fluctuations from October 2018 to September 2019. Conclusion Despite the introduction and use of medical cannabis therapy, with both THC and CBD components, an elderly patient with concurrent warfarin use did not see major INR fluctuations, in contrast to published literature. The potential for warfarin and THC/CBD interactions may be dependent on route of administration and dose of the cannabis product.

This chapter will explore the connection between diversifying health profession student demographics, diversifying challenges these students face, and the new obstacles presented by shifting curriculum delivery to remote and hybrid learning during the coronavirus disease 2019 (COVID-19) pandemic. The chapter will explore challenges that may seem especially difficult to address in a remote learning model: the desire to develop community among fellow learners when in a hybrid or fully remote program and when learners are from varied backgrounds; cultivating in students coping mechanisms to manage anxiety from the economic uncertainty of today's world, balancing commitments between educational pursuits and other responsibilities (e.g., child or parent care, etc.); and facilitating learning for students with physical and/or mental disabilities or chronic medical conditions.

Objective. To describe a novel design on teaching dyslipidemia management that would help students compare and apply past and current clinical recommendations using a variety of new mechanisms. Methods. Didactic time consisted of three sections: lecture; faculty-led panel discussion; and interactive, progressive, student-driven patient case. The accompanying case studies course involved varying interactive student activities, including literature review, adverse event reporting, and immediate feedback assessment tools. Results. Students performed well on audience response questions, dyslipidemia examination questions, and in-class case studies activities. Subjective student and faculty feedback were positive for the entire innovation. Conclusion. The redesigned dyslipidemia module gives students exposure to overall management of this disease state through several innovative approaches that can be repeated in other courses to enhance learning.