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Objectives. To implement and assess the effectiveness of online instructional modules to increase the consistency of learning outcomes related to students' patient-care practice knowledge and their skills application and confidence across introductory pharmacy practice experience (IPPE) sites. Design. Twenty online modules were created to provide uniform delivery of instructional content that complemented classroom instruction and to introduce students to common pharmacy-practice skills in the patient-care arena. Assessment. Quantitative data were collected by means of a survey and pre-and post-module quizzes, which were completed by students to assess knowledge. More than 85% of students applied the IPPE skills. During the course, students' confidence increased significantly in all areas. For all but 1 of the 13 competencies, more than 70% of students agreed or strongly agreed that the competencies were met. Conclusions. Online instructional modules in patient care can effectively increase students' knowledge, skills application, and confidence, and improve the consistency of achieving outcomes for instructional content and activities across diverse practice settings.

Objective. To cross reference the core entrustable professional activities (EPAs) to a complete set of educational guidance documents for the Doctor of Pharmacy (PharmD) curriculum to create a map for pharmacy educators. Methods. The Mapping EPAs Task Force consisted of nine members who first worked independently and then together in small working groups to map five assigned educational guidance documents (eg, Center for the Advancement of Pharmacy Education [CAPE] Outcomes, Accreditation Council for Pharmacy Education [ACPE] Standards 1-4, and the Essential Elements for Core Advanced Pharmacy Practice Experiences [APPEs]) to the Core Entrustable Professional Activities for New Pharmacy Graduates. Four working groups completed the mapping process during phases 1 and 2, which was followed by an independent quality assurance review and consensus in phase 3. Results. All 15 core EPA statements were mapped to one or more of the educational documents. One item from the CAPE Outcomes could not be mapped to a core EPA statement. The first five EPA statements mapped directly to the five elements of the Pharmacists' Patient Care Process: collect, assess, plan, implement, and follow-up: monitor and evaluate. Conclusion. This comprehensive EPA map is the first curriculum crosswalk that encompasses a complete set of educational guidance documents including the Essential Elements for Core APPEs for the Doctor of Pharmacy curriculum. If adopted by the Academy, this curriculum crosswalk will provide pharmacy schools with a common interpretation of important educational guidance documents; serve as the foundation for curricular development, revision, and assessment; and ensure student pharmacists are prepared to enter the pharmacy profession.

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Hyperprolactinemia is a well-known consequence of conventional antipsychotic therapy. The atypical antipsychotic clozapine is reported to lack this effect. We describe a case of attenuated serum prolactin levels after conversion to clozapine therapy in an adolescent. A 13-year-old female patient developed hyperprolactinemia with galactorrhea and amenorrhea while receiving thioridazine 300 mg daily. These symptoms continued throughout 3 years of treatment with haloperidol 10 mg daily and then fluphenazine 10 mg daily. Subsequently, after an incomplete improvement in her psychiatric symptoms and hyperprolactinemia on thioridazine 150 mg and bromocriptine 15 mg daily, the patient was changed to clozapine at age 16. Clozapine 150 mg twice daily improved her psychiatric status and corrected her serum prolactin concentrations after 2 weeks; bromocriptine was able to be discontinued. We recommend systematic evaluation of atypical neuroleptics as alternative treatments for refractory hyperprolactinemia induced by conventional antipsychotics.

A 48 year-old white male not suffering from endocrine disease or polydipsia, not taking diuretics, and suffering from no renal disease was started on risperidone and discharged on no other drug from Western Missiouri Mental Health Center (WMMHC) after an 8-day hospitalization. Seven days later he was admitted to a university medical center with generalized seizures, hyponatremia, respiratory failure, and rhabdomyalysis. He eventually recovered, was transferred back to WMMHC, and stabilized on appropriate medication. A search of the literature indicates no case reports linking risperidone to hyponatremia. It is assumed that the mechanism of hyponatremia is similar to other psychotropic medication in that it is secondary to the syndrome of inappropriate antidiuretic hormone (SIADH).

It has been reported in the literature that phencyclidine (PCP) psychosis recovery may take up to 4-6 weeks. This retrospective review sought to determine whether patients with a new onset of PCP psychosis have a longer hospitalization than those patients with new onset functional psychosis. The PCP arm (N = 20) was found to have a significantly shorter hospitalization than those with a new onset functional psychosis (N = 20)-mean 4.8 days (range 1-9) versus 13.6 days (range 3-41), p < .05. In addition, patients with psychosis related to PCP use were treated more aggressively with conventional antipsychotics than patients with a new onset functional psychosis at this facility.