Objective. To determine if the process-oriented guided inquiry learning (POGIL) teaching strategy improves student performance and engages higher-level thinking skills of first-year pharmacy students in an Introduction to Pharmaceutical Sciences course. Design. Overall examination scores and scores on questions categorized as requiring either higherlevel or lower-level thinking skills were compared in the same course taught over 3 years using traditional lecture methods vs the POGIL strategy. Student perceptions of the latter teaching strategy were also evaluated. Assessment. Overall mean examination scores increased significantly when POGIL was implemented. Performance on questions requiring higher-level thinking skills was significantly higher, whereas performance on questions requiring lower-level thinking skills was unchanged when the POGIL strategy was used. Student feedback on use of this teaching strategy was positive. Conclusion. The use of the POGIL strategy increased student overall performance on examinations, improved higher-level thinking skills, and provided an interactive class setting.Keywords: POGIL, active learning, process skills, instructional assessment INTRODUCTIONDeveloping students' critical-thinking and problemsolving skills is an educational goal common to perhaps every academic program or discipline. Critical to achieving this goal is the use of teaching and learning strategies that engage students and promote development of the process skills of application, analysis, and evaluation. Yet, despite a growing body of evidence demonstrating the efficacy and superiority of active-learning strategies and national reports calling for the adoption of these methods, 1-4 instructional strategies in science and math disciplines tend to be passive, leading to student disengagement and contributing to the "leaky pipeline" of science. [5][6][7][8][9] The reasons science faculty members give for being reluctant to adopt active-learning strategies include the significant amount of time needed to prepare materials, the reluctance to reduce the amount of material covered, and the perception that students are unwilling to engage in or prepare for these types of classroom activities. [10][11][12] In the pharmacy academy, active-learning strategies are recognized as important to achieving educational outcomes and, therefore, widely adopted in professional programs. [13][14][15] However, the use of active-learning strategies is not uniformly distributed. Faculty members in the biomedical and pharmaceutical sciences are 3 times less likely than faculty members in the clinical and social and administrative sciences to use these techniques. 15 Process-oriented guided inquiry learning (POGIL) is a teaching strategy that was initially developed in college chemistry and biology courses and is used successfully to engage students in the classroom and to promote learning. [16][17][18][19][20] The POGIL strategy begins with introducing students to a model, diagram, problem, or set of data and then requires them to ...

The use of prasugrel or ticagrelor as part of triple antithrombotic therapy among patients who underwent PCI and received warfarin was associated with significantly more bleeding compared to patients who received clopidogrel. Therefore, higher potency P2Y inhibitors should be used cautiously in these patients.

There is limited data regarding the feasibility of transitioning from intravenous prostacyclins to selexipag in pulmonary arterial hypertension (PAH) patients. We present a case series of successful transitions from intravenous prostacyclins to selexipag in the majority of carefully selected five stable PAH patients using a standardized protocol in the outpatient setting.

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder characterized by unexplained left ventricular hypertrophy in the absence of other cardiac or systemic etiologies. Approximately two-thirds of patients with HCM develop left ventricular outflow tract (LVOT) obstruction with or without provocation, whereas nearly half develop heart failure with preserved ejection fraction. Medical management of heart failure with preserved ejection fraction is based on the presence of symptoms and LVOT obstruction and frequently includes β-blockers or verapamil. Disopyramide is a class Ia antiarrhythmic that historically was used for the treatment of arrhythmias; however, its contemporary use is often reserved for patients with HCM who are persistently symptomatic despite β-blockers or verapamil and have evidence of LVOT obstruction. The pharmacologic rationale for use of disopyramide is largely based on its strong negative inotropic property. Three clinical studies have showed significant improvements in heart failure symptoms and a reduction in the need for invasive therapy in patients treated with disopyramide. Appropriate dosing and monitoring of disopyramide are important to mitigate the potential for anticholinergic adverse events and proarrhythmias. Disopyramide is a safe and effective medication that reduces heart failure symptoms and LVOT gradient and delays the need for invasive therapy in patients with obstructive HCM.