Objective. To implement and assess the effectiveness of a capstone pharmacotherapy course designed to integrate in-class curriculum using patient cases and drug-information questions. The course was intended to improve third-year doctor of pharmacy (PharmD) students' clinical documentation skills in preparation for beginning advanced pharmacy practice experiences (APPEs). Design. This 2-credit, semester-long course consisted of 6 patient cases and 12 drug-information questions posted electronically on an Internet-based medical chart, a public health presentation, a knowledge examination, and an objective standardized performance assessment. In class, students engaged in active-learning exercises and clinical problem-solving. Students worked outside of class in small groups to retrieve and discuss assigned articles and review medication information in preparation for in-class discussions. Assessment. A rubric was used to assess the patient cases and questions that students completed and submitted individually. Data for 4 consecutive course offerings (n5622) were then analyzed. A significant improvement was found in the "misplaced" but not the "missing" documentation ratings for both assessment and plan notes in the final assessment compared with baseline. In course evaluations, the majority of students agreed that the course integrated material across the curriculum (97%) and improved their clinical writing skills (80.5%). Conclusion. A capstone pharmacy course was successful in integrating and reviewing much of the material covered across the PharmD curriculum and in improving students' clinical documentation skills.

There is considerable variability in the total phenytoin concentrations in the elderly nursing home resident and measurement of a single total phenytoin concentration should not be used to guide treatment.

Carbamazepine is a widely prescribed antiepileptic drug. Due to a lack of an intravenous formulation, its absolute bioavailability, absolute clearance, and half-life in patients at steady state have not been determined. We developed an intravenous, stable-labeled (SL) formulation in order to characterize carbamazepine pharmacokinetics in patients. Ninety-two patients received a 100 mg infusion of SL-carbamazepine as part of their morning dose. Blood samples were collected up to 96 hours after drug administration. Plasma drug concentrations were measured with LC-MS and concentration-time data were analyzed using a noncompartmental approach. Absolute clearance (L/hr/kg) was significantly lower in men (0.039±0.017) than women (0.049±0.018;p=0.007) and in African Americans (0.039±0.017) when compared to Caucasians (0.048±0.018;p=0.019). Half-life was significantly longer in men than women as well as in African Americans when compared to Caucasians. The absolute bioavailability was 0.78. Sex and racial differences in clearance may contribute to variable dosing requirements and clinical response.

Objectives. To integrate an Internet-based medical chart (IMC) system into a pharmacotherapy course to facilitate evaluation and feedback processes, foster development of written documentation skills, and prepare pharmacy students for future changes in electronic medical documentation systems.Design. An IMC system was introduced into a pharmacotherapy course for third-professional year pharmacy students and 4 ''finish the SOAP note'' activities were added to the curriculum. Students' performance on the SOAP notes were assessed by a team of evaluators. At the end of the semester, students and evaluators completed separate 6-item survey instruments concerning the usefulness of the IMC system in meeting the course objectives. Assessment. Students' performance on documentation activities improved over the course of the semester: 87% of the students avoided repeating previous mistakes by their final documentation activity. The vast majority of the students and evaluators found the system easy to use and the activities helpful. Conclusion. The development, implementation, and initial expansion of the IMC system across both laboratory and pharmacotherapy courses was a success. Continued integration into clinical coursework is planned and will further expand opportunities for applied learning experiences to prepare students for their experiential program and beyond.

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