CANPA Annual Conference: Bradley Lecture Center at Childrens of Alabama

Brooks Vaughan: Dyslipidemia Throughout the Lifespan

Objectives:

1. Understand the risk factors for ASCVD throughout the lifespan
2. Understand and implement the current pediatric and adult guidelines regarding ASCVD and treatment
3. Review statins and their use in lowering LDL
4. Understand new research on aspirin and CVD
5. Discuss liver disease and statin use
6. Review monitoring recommendations for patients on statins

Short Abstract:

                This presentation with be a discussion of known cardiovascular risk factors in children and adults for ASCVD. We will review the most recent guidelines for treatment of hyperlipidemia in all age groups, with a focus on statin therapy. We will discuss aspirin and its role in ASCVD prevention and the use of statins in specific circumstances such as liver disease.

General Outline:

1. Objectives
2. Pediatric risk factors for ASCVD
3. Pediatric treatment guidelines
4. Adult treatment guidelines
5. Aspirin therapy
6. Statins and the liver

Evaluation and management of hypertriglyceridemia

Podium presentation abstract

Hypertriglyceridemia (HTG) is increasingly common in the United States (US), is associated with life-threatening pancreatitis and increased atherosclerotic cardiovascular disease (ASCVD) risk, and is often asymptomatic. Patients presenting with hypertriglyceridemia should be evaluated for secondary causes including diabetes mellitus, acute/chronic kidney disease, nephrotic syndrome, hypothyroidism, certain medications, and alcohol abuse. Adults should be screened at least every five years as part of a global risk assessment and more frequently if abnormalities occur or if there is a family history of ASCVD. Although patients are often asymptomatic, once triglycerides exceed 500 mg/dL, the presentation can change drastically and patients can present with xanthomas, lipemia retinalis, and acute pancreatitis. In addition to treating or eliminating secondary causes of HTG, there are lifestyle and medical interventions that can be instituted to decrease associated risks. Physical activity can lower TG by up to 37% and a 5-10% sustained weight loss can lower TG by 20%. Dietary modifications are often necessary for all patients with HTG and consist of reducing simple carbohydrates, alcohol, trans and saturated fat, and fructose intake, in addition to increasing fiber and omega-3 fatty acids. Statins are often considered first line treatment for triglycerides less than 500 mg/dL and may decrease plasma TG level by up to 30%. Fibrates decrease TG by up to 62% by activating peroxisome proliferator-activated receptor alpha. Prescription strength long-chain omega-3 fatty acids decrease plasma TG by up to 45% through an unknown mechanism and are considered relatively safe with no identified safety issues. Although rarely used secondary to side effects, niacin, or vitamin B3 can lower TG levels at high doses.

Objectives

1. Discuss diagnosis and screening mechanisms associated with hypertriglyceridemia
2. Discuss complications and primary/secondary causes of hypertriglyceridemia
3. Identify therapeutic interventions to treat hypertriglyceridemia

1. Define polycystic ovary syndrome (PCOS)
2. Discuss phenotypic characteristics and variations of the PCOS patient
3. Review cardiometabolic manifestations of PCOS
4. Delineate strategies to limit cardiometabolic risks in the PCOS patient

Annette Hess

Abstract:

The prevalence of diabetes is at an epidemic increase and has been over the past several years around the world. Over the course of decades, scientists have searched for methods to mimic physiologic insulin action for optimal glycemic outcomes. Therefore, the development of new insulins and anti-hyperglycemic agents are emerging at a fast pace. Health care providers must continuously stay abreast and understand the use of the newest techolognies and medications to effectively manage diabetes type 1 and type 2. Diabetes treatment and management strategies have become the greatest challenge for providers as well as for the individuals with diabetes. Heathcare provider and patient education on the ever-changing, most effective diabetes treatment modality is critical for improving glycemic outcomes.The results of newer generation of drugs like Incretin mimetics, Amylin analogues, GIP analogs, Peroxisome proliferator activated receptors, dipeptidyl peptidase-4 inhibitor ultra-long and ultra-rapid acting insulin, sulphonylureas, biguanides, alpha glucosidase inhibitors, thiazolidinediones, and more will be reviewed during the presentation.

Review the Healthy People 2020 statement and epidemiology of diabetes.

Review the diagnostic criteria and glycemic control for diabetes mellitus.

Identify and discuss healthier lifestyles for healthier outcomes

List and describe anti-diabetes medications with a focus on new

Oral medications

GLP-1 receptor agonists injectables

Insulins

Develop

Develop a plan for patient-centered care coordination and communication in the management of pediatric patients with diabetes.

Describe

Describe Pathophysiology of type 1 and type 2 diabetes

Recognize

Recognize the association of Diabetes with other autoimmune disorders

Demonstrate

Demonstrate treatment plan for prescribing insulin

OBJECTIVES

• Discuss the prevalence and impact of hypertension
• Discuss the pathophysiology of hypertension and how it can affect the body
• Discuss the two classes of hypertension
• Discuss the latest guidelines for treating hypertension
• Discuss the classifications of drug therapy and the non-pharmacologic recommendations for treating hypertension

ABSTRACT

Hypertension is the most common Cardiovascular Disease affecting approximately 103 million adults in the US.  It is the leading cause of stroke and a major cause of heart attack.  Hypertension tends to develop slowly over time.   It cannot be cured but can be managed effectively.  There are many options for treating high blood pressure including non-pharmacologic and pharmacologic strategies.   Based on evidenced based practice, the 2017 ACC/AHA guideline provides an algorithm to effectively treat patients with hypertension and minimize the long term effects of this disease. 

OUTLINE

1. Hypertension Statistics
2. Pathophysiology of Hypertension
3. Classes of Hypertension
4. Effects of Hypertension on the Body
5. Analyzing the Guidelines
6. Non-Pharmacologic Recommendations
7. Pharmacologic Treatment Option – Classes and Actions
8. Case Studies

Fostering Self-Management Skills to the Obese Patient
Brandy S. Young

Objectives
1. Participants will understand and be able to apply self-management techniques to help foster health care.
2. Participants will gain understanding of how pharmacological measure utilized to help aid in self-management of the obese patient.
3. Participants will be able to apply appropriate codes and understand CMS reimbursement when fostering self-management techniques to the obese patient.

Abstract

Obesity rates continue to escalate in the US and account for massive healthcare resources spent
annually. Resources spent are directly related with multiple chronic concomitant conditions
associated with obesity. The Patient Protection and Affordable Care Act (PPACA) outlines the
framework of self-management. Self-management is an intervention for chronic condition management
emphasizing empowerment of patients to take charge of healthcare. The purpose of this qualitative
pilot study is to evaluate the effectiveness of an individualized educational plan used to inform
and engage obese patients in self-management.

Results, data analysis and conclusion pending.

Keywords: self-management, chronic disease, multiple chronic conditions

NPAA Legislative Update 2019

Objectives

1. Describe the importance of membership for professional organizations at the local, state,

and national level.

2. Describe the process NPAA uses to create a legislative agenda each year.

3. Describe pending Alabama Medicaid changes and how it will affect the practice of the NP.

4. Describe AANP’s top three health policy topics for 2019 and how it affects NPs.

5. Describe the opportunities for policy advancement for Alabama in 2019.

Abstract

The 2019 legislative session is now in session and advocacy on behalf of your

profession is critical to our future success. The purpose of this lecture is to educate the nurse

practitioners of current legislation that aims to remove barriers to practice in the Medicare and

Medicaid System.

W Joys slides

Student Poster A: Amber Evans

Student Poster B: Letisha Scott

Student Poster C: Angela Metcalf

Student Poster D: Staci Abernathy

Student Poster E: