All speakers participating in this conference have no relevant conflicts of interest to disclose. 1

Conference Agenda & Education Information Schedule & sessions subject to change.

FRIDAY, OCTOBER 25, 2019

Pediatric Primer Workshop* ....................................................................... 12:30 PM - 6:00 PM (Room: Hidalgo) UAN: 0156-0000-19-252-L04-P & 0156-0000-19-252-L04-T (0.5 CEUs) Type: Application-based Compounding Medications for Pediatric Patients Learn about compounding for pediatrics from birth to adult and the challenges practitioners face.

Lisa D. Ashworth, BS Pharm, RPh, FACA Compounding Specialist and Clinical Pharmacist Children's Health System of Texas Dallas, Texas

Myths and Facts of Pediatric Pharmacotherapy This session will provide the audience with an introduction to general concepts of pediatric pharmacotherapy that influence medication use in this unique population. The presentation will review developmental differences observed in the pediatric patient compared to the adult patient. The audience will be presented with patient cases and asked to identify relative and absolute contraindications to medication therapy in the pediatric population using knowledge of any developmental differences. The patient cases will explore common diseases states encountered in the pediatric population so that the audience gains confidence in making appropriate drug therapy recommendations across a wide range of ages in the pediatric population.

Kathryn Givens Merkel, PharmD, BCPS, BCIDP, BCPPS Clinical Pharmacy Manager St. David’s South Austin Medical Center Austin, Texas

Multimodal Pain Management on Sickle Cell Patients with Acute Pain Crisis Severe acute pain is the most common manifestation of the Sickle Cell Disease. However, pain management is only one of a multitude of complications that accompanies a pain crisis. However, multimodal pharmacological and non-pharmacological treatment has help reduce patient’s pain score in the hospital and at home.

Chi Pham-Peyton, PharmD, BCPPS Pediatric Clinical Pharmacist Memorial Hermann, Memorial City Houston, Texas

General Pediatrics 101 Pharmacists must be knowledgeable with pediatrics in order to provide optimal patient care. This session will discuss general pediatric definitions, common medication errors associated in these populations, and best practices to care for pediatric patients. This session will also cover lessons learned from practicing in the largest freestanding pediatric hospital in the nation.

All speakers participating in this conference have no relevant conflicts of interest to disclose. 2

Stephen J. Davis, PharmD, MS, FASHP Director, Health System Strategy Shields Health Solutions Houston, Texas

At the completion of this activity, the pharmacist participant will be able to:

• Explain some challenges in choosing a vehicle, stability, and flavoring. • Discuss some adverse effects that can occur from them vehicles and flavorings. • Describe the differences in potency and texture that may occur in using a commercial product or a raw

material as the active pharmaceutical ingredient (API). • Describe the complexity of Sickle Cell Disease • Review literature regarding pharmacological pain therapies in sickle cell patients • Apply multimodal pain regimens to treat sickle cell patients with acute pain crises • Describe developmental differences between pediatric patients and adult patients. • Predict potential drug-related problems in pediatric patients. • Justify medication use in common pediatric disease states. • Discuss pediatrics age definitions • Recommend strategies to minimize common medication errors in these populations • Apply best practices for pediatric pharmacy services

At the completion of this activity, the technician participant will be able to:

• Explain some challenges in choosing a vehicle, stability, and flavoring. • Discuss some adverse effects that can occur from them vehicles and flavorings. • Describe the differences in potency and texture that may occur in using a commercial product or a raw

material as the active pharmaceutical ingredient (API). • Describe the complexity of Sickle Cell Disease • Review literature regarding pharmacological pain therapies in sickle cell patients • Apply multimodal pain regimens to treat sickle cell patients with acute pain crises • Recognize developmental pharmacokinetic parameters observed in the pediatric population. • Discover medications that are not recommended in select pediatric patients. • Identify medications used in common pediatric disease states. • Discuss pediatrics age definitions • Recommend strategies to minimize common medication errors in these populations • Apply best practices for pediatric pharmacy services

*Additional registration required. Participants must attend all portions of the workshop to receive CPE credit.

SATURDAY, OCTOBER 26, 2019

Registration ......................................................................... 7:00 AM - 5:00 PM (Room: Grand Ballroom Foyer) Welcome & Keynote Breakfast ................................................. 7:30 AM - 9:00 AM (Room: Grand Ballroom)

KEYNOTE: Emily Jerry’s Story: From Heartbreak to Victory - Saving Lives by Preventing Errors Before They Happen!

All speakers participating in this conference have no relevant conflicts of interest to disclose. 3

UAN: 0156-0000-19-253-L05-P & 0156-0000-19-253-L05-T (0.1 CEUs) | Type: Knowledge-based | Category: Foundational Ever since Emily Jerry’s tragic death, over 13 years ago from a preventable medication error, Chris began a very unintentional quest, he has always believed was chosen for him, to work diligently to affect positive change in medicine. Consulting with some of the brightest minds in healthcare, he has helped to transform the culture of medicine, how it is practiced in the U.S., and more importantly how we respond and learn from these preventable errors which have now been identified as being the third leading cause of death in the United States . Chris founded the Emily Jerry Foundation, in honor of his daughter’s name, to focus attention on the underlying systems, processes, and protocols in medicine, and to find comprehensive solutions that minimize this inherent “human error component of medicine.” Following Emily’s tragic medication error, he identified where and how the human error occurred and, subsequently, found solutions to prevent this from ever happening again. The foundation began in August of 2009 in the state of Ohio shortly after the passage of “Emily’s Law”. At the completion of this activity, the pharmacist and technician participant will be able to:

• Discuss the events surrounding the medical error that resulted in Emily Jerry’s tragic death in 2006.

• Discuss how very basic IV workflow technology, with integrated barcode verification, would have prevented Emily’s tragic death.

• Describe the importance of being proactive in identifying where “human error” can creep into your pharmacy workflow.

• Discuss how today’s clinically proven technology can only save lives if coupled with ever evolving best pharmacy practices.

• Discuss why the state of Texas received an “A” score from ASHP on the EJF National Pharmacy Technician Initiative and Interactive Scorecard

• Explain the vital role that pharmacy technicians play in the overall safe pharmacy practice.

Christopher S. Jerry President & CEO Emily Jerry Foundation for Patient Safety

Concurrent Educational Sessions ....................................................................................... 9:00 AM - 10:00 AM

Snakes and Spiders and Raccoons, Oh My! Treating Animal Bites in the Pediatric Emergency Department (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-254-L01-P & 0156-0000-19-254-L01-T (0.1 CEUs) | Type: Knowledge-based | Category: Foundational This presentation will cover pharmacotherapy options for animal bites, including bites from mammals, snakes, and spiders, in addition to stings from caterpillars, scorpions and jellyfish. Discussion of rabies prophylaxis, bite-related skin & soft tissue infection prophylaxis and treatment, rabies virus treatment options, procedures to obtain rare snake antivenins, key compounding points for antivenins and non-pharmacologic care of jellyfish and caterpillar stings will additionally be addressed. At the completion of this activity, the pharmacist and technician participant will be able to:

• Recognize which animal bites and stings require pharmacologic treatment • Propose a treatment plan for a pediatric patient who requires rabies post-exposure prophylaxis • Identify key compounding points for snake and spider antivenin • Differentiate between home remedies and proven treatments for jellyfish stings

All speakers participating in this conference have no relevant conflicts of interest to disclose. 4

Courtney Kain, PharmD, MS, BCPPS Clinical Pharmacy Specialist Texas Children’s Hospital West Campus Houston, Texas

The Next Phase in Automation: IV Robotics with Smart Pump Technology (Room: Hidalgo/Navarro) UAN: 0156-0000-19-255-L01-P & 0156-0000-19-255-L01-T (0.1 CEUs) | Type: Application-based | Category: Operational Ongoing advances in pharmacy technology provide opportunities to improve the quality of care and the patient safety of IV compounded products administered by smart pumps. Many considerations must be taken into account during the assessment and implementation of these technological enhancements. IV robotics and smart pump interoperability complement each other in promoting safer preparation and administration of medications when dispensed as standardized volumes from automated dispensing cabinets. At the completion of this activity, the pharmacist and technician participant will be able to:

• Explain the rationale for implementation of IV automation technology • Investigate and interpret the considerations necessary for IV robotics implementation • Explain the functionality of smart pump interoperability and its role in enhancing quality of care

and patient safety • Evaluate how smart pump interoperability can influence the selection of standardized volumes

to be prepared by IV robotics and dispensed from automated dispensing cabinets Eric Espineli, PharmD, RPh Pharmacy Informaticist Texas Children's Hospital Houston, Texas Jennifer Randazzo, RPh Pharmacy Informaticist Texas Children's Hospital Houston, Texas

Concurrent Educational Sessions .................................................................................... 10:05 AM - 11:05 AM

The Scary Truth About Gram-negative Bacterial Resistance and New Agents to Treat Them (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-256-L01-P & 0156-0000-19-256-L01-T (0.1 CEUs) | Type: Application-based | Category: Advanced Clinical Antimicrobial resistance has been increasing globally and has reached a point that the World Health Organization (WHO) identifies as a major threat to humanity. In the United States, data from the Centers for Disease Control and Prevention suggest that more than 2 million infections each year are caused by resistant organisms and that antimicrobial resistance is blamed for 23,000 deaths annually. Some common mechanisms of Gram-negative antimicrobial resistance include the production of enzymes that degrade antibiotics (e.g., beta-lactamases); upregulation or reduction of membrane porins that reduce intracellular drug concentrations; or modifications to the target binding site. Newer antimicrobial agents that have been

All speakers participating in this conference have no relevant conflicts of interest to disclose. 5

introduced to market (e.g., aztreonam/avibactam, cefiderocol, eravacycline, and ceftolozane/tazobactam plazomicin, to name a few), but what is their role in pediatrics? At the completion of this activity, the pharmacist and technician participants will be able to:

• Distinguish the mechanisms contributing to resistance in Gram-negative bacteria • Describe new antibacterial agents on the market to target resistant Gram-negative bacteria • Justify appropriate use of the new antibacterial agents in resistant Gram-negative infections in

pediatric patients

Sarah Kubes, PharmD, BCPS Clinical Assistant Professor and Pediatric Clinical Specialist Pharmacist UT College of Pharmacy and University Health Systems Austin, Texas

Hillary Orr, PharmD Pediatric Clinical Pharmacy Specialist Pediatric/Cardiovascular Intensive Care Unit & Antimicrobial Stewardship Children’s Memorial Hermann Hospital Houston, Texas

Just a Matter of Time: Every Second Counts with Neonatal Sepsis (Room: Hidalgo/Navarro) UAN: 0156-0000-19-257-L01-P & 0156-0000-19-257-L01-T (0.1 CEUs) | Type: Application-based | Category: Advanced Clinical Neonatal sepsis is one of the leading causes of morbidity and mortality in term and preterm infants. In this program, we will discuss strategies to reduce unnecessary antibiotic exposure to those neonates in the early part of their lives. Specifically, we will review literature on the use of neonatal sepsis calculators and determine the optimal “rule-out” sepsis antibiotic duration.

At the completion of this activity, the pharmacist participants will be able to:

• Review the current treatment strategy for early-onset neonatal sepsis • Evaluate the optimal “rule-out” duration of antibiotics use in neonatal sepsis • Analyze the current literature supporting the use of neonatal sepsis calculators

At the completion of this activity, the pharmacist participants will be able to:

• Review the current treatment strategy for early-onset neonatal sepsis • Discuss the optimal “rule-out” duration of antibiotics use in neonatal sepsis • Review the current literature supporting the use of neonatal sepsis calculators

Jessica Jacob, PharmD, BCPPS Clinical Pharmacy Specialist Pediatrics and the Neonatal Intensive Care Unit Hendrick Medical Center Abilene, Texas

Lunch with Exhibitors ............................................................... 11:15 AM - 1:00 PM (Room: Grand Ballroom) Concurrent Educational Sessions .......................................................................................... 1:00 PM - 2:00 PM

All speakers participating in this conference have no relevant conflicts of interest to disclose. 6

Thinning the Herd: Anti-Vaccination Psychology (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-258-L06-P & 0156-0000-19-258-L06-T (0.1 CEUs) | Type: Knowledge-based | Category: Foundational This continuing education activity will provide a comprehensive review of the history of anti-vaccination sentiments of the 1800’s through the recession of anti-vaccine thinking in the 1940’s through 1970’s and subsequent rise in the anti-vaccination movement. This activity will address reasons for parental vaccine refusal, use concepts from psychology to amplify understanding of parental confidence gaps leading to vaccine refusal, and suggest strategies to assist pharmacists when discussing these issues with vaccine-hesitant or –resistant parents. At the completion of this activity, the pharmacist and technician participant will be able to:

• Discuss the history of vaccine hesitancy • Explain commonly cited reasons for parental vaccine refusal • Discuss the vaccine confidence gap using insights from psychology • Highlight strategies for discussing vaccination with vaccine-hesitant or -resistant parents

Sara Liechti, PharmD Clinical Pharmacy Specialist Texas Children's Hospital Houston, Texas Emily Rodman, PharmD, BCPPS Clinical Pharmacy Specialist Texas Children's Hospital Houston, Texas

Cystic Fibrosis: Modulating the Future of Disease Progression (Room: Hidalgo/Navarro) UAN: 0156-0000-19-259-L01-P & 0156-0000-19-259-L01-T (0.1 CEUs) | Type: Application-based | Category: Advanced Clinical This presentation will provide a brief background on the pathophysiology of cystic fibrosis, the symptoms of the disease, and the standard treatments to treat the symptoms. The focus of the presentation will be regarding the data surrounding the use of cystic fibrosis transmembrane conductance regulator modulators: their mechanism of action, place in treatment, and outcomes. Lastly, the affect that these new medications have on disease progression will be discussed. At the completion of this activity, the pharmacist participant will be able to:

• Describe the pathophysiology and clinical symptoms of cystic fibrosis (CF) • Discuss standard treatments for patients with CF • Analyze data supporting the use of new CFTR modulators • Determine the potential impact CFTR modulators have on CF disease progression

At the completion of this activity, the technician participant will be able to:

• Describe the pathophysiology and clinical symptoms of cystic fibrosis (CF) • Discuss standard treatments for patients with CF • Review data supporting the use of new CFTR modulators • Discuss the potential impact CFTR modulators have on CF disease progression

All speakers participating in this conference have no relevant conflicts of interest to disclose. 7

Erin J. McDade, PharmD, BCPPS Assistant Director - Clinical Pharmacy Services and Outcomes Texas Children's Hospital Houston, Texas

Concurrent Educational Sessions .......................................................................................... 2:05 PM - 3:05 PM

Little People Problems in a Big World: USP 800 Implementation (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-260-L07-P & 0156-0000-19-260-L07-T (0.1 CEUs) | Type: Knowledge-based | Category: Operational The purpose of this presentation will be to review USP 800 regulations affecting pediatric hospital pharmacies. During this presentation we will highlight some of the hardships and risks specific to pediatric hospitals with the implementation of USP 800. We will describe the challenges faced at Children’s Memorial Hermann Hospital, a children’s hospital within an adult hospital and large health system. At the completion of this activity, the pharmacist and technician participant will be able to:

• Review new USP 800 regulations • Identify NIOSH risk categories and corresponding safe handling requirements • Describe challenges pharmacy and pharmacy personnel may encounter implementing these new

standards Matthew Martin-Souza, Pharm.D. Pediatric Clinical Pharmacist Children's Memorial Hermann Hospital Houston, Texas

Oncologic Emergencies in Pediatric Oncology (Room: Hidalgo/Navarro) UAN: 0156-0000-19-261-L01-P & 0156-0000-19-261-L01-T (0.1 CEUs) | Type: Application-based | Category: Advanced Clinical In this session, participants will review the pathophysiology and risk factors of oncologic emergencies seen in the pediatric population. They will also evaluate approaches to the management and evaluation of children with oncologic emergencies, using a case-based approach. Important principles will be enforced through active participation of the audience in round-table discussion of cases and the potential therapeutic approach. At the completion of this activity, the pharmacist participant will be able to:

• Discuss the pathophysiology and risk factors for three specific pediatric oncologic emergencies • Anticipate changes in the laboratory parameters and necessary monitoring parameters for

children with oncologic emergencies • Formulate a treatment plan based on patient-specific information

At the completion of this activity, the technician participant will be able to:

• Discuss the pathophysiology and risk factors for three specific pediatric oncologic emergencies • Review changes in the laboratory parameters and necessary monitoring parameters for children

with oncologic emergencies • Assist in the formulation of a treatment plan based on patient-specific information as part of the

patient care team

All speakers participating in this conference have no relevant conflicts of interest to disclose. 8

Brooke Bernhardt, PharmD, MS, BCOP, BCPPS Assistant Professor, Department of Pediatrics Section of Pediatric Hematology/Oncology Baylor College of Medicine Houston, Texas

Refreshment Break ...................................................................... 3:00 PM - 4:00 PM (Room: Grand Ballroom) Concurrent Educational Sessions ......................................................................................... 4:00 PM - 5:00 PM

Lipidpalooza: Which lipid emulsion should I choose? (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-262-L01-P & 0156-0000-19-262-L01-T (0.1 CEUs) | Type: Application-based | Category: Foundational There has been a recent increase in the use of alternative lipid emulsion products in neonatal and pediatric parenteral nutrition. With recent Federal Drug Administration (FDA) approvals of a mixed lipid emulsion in 2016 and fish oil emulsion in 2018, many institutions are being asked by providers to add these products to formulary. The aim of this presentation is to review the use of lipid emulsions in neonatal and pediatric patients, while comparing the three main lipid products available on the market and their utility in these patient populations. At the completion of this activity, the pharmacist and technician participant will be able to:

• Explain the use of lipid emulsions in neonatal and pediatric parenteral nutrition • Compare and contrast the most commonly used lipid products available on the market • Discuss appropriate use of newer lipid emulsions and evaluate potential dosing strategies when

using these products

Jordan Burdine, PharmD, MBA, BCPPS Clinical Pharmacy Practice Specialist Pediatrics and Neonatology UTMB Health Galveston, Texas

Play to Your Strengths: Developing a Pediatric Rotation in a Non-Traditional Setting (Room: Hidalgo/Navarro) UAN: 0156-0000-19-263-L04-P (0.1 CEUs) | Type: Application-based | Category: Operational This presentation will discuss opportunities to develop pediatric IPPE and APPE rotations in communities that lack large pediatric institutions. Examples will be drawn from a pediatric APPE rotation through TTUHSC Jerry H. Hodge School of Pharmacy in Abilene, Texas. This rotation includes experiences across a breadth of pediatric practice sites, including the NICU and pediatric units of a regional medical center, a pediatric specialty outreach clinic, a pediatric primary care clinic, and an independent compounding pharmacy. Faculty will describe the rotation structure, lessons learned, and how to maximize opportunities for students in a community hospital and ambulatory setting. At the completion of this activity, the pharmacist participant will be able to:

• Identify opportunities to expose students to pediatric pharmacy outside of large pediatric institutions

• Describe resources needed to develop a successful pediatric rotation in a community setting • Apply minimum standards for pharmacists in pediatric practice to rotation content • Develop creative solutions to roadblocks (e.g. low patient census, limitations on student

numbers)

All speakers participating in this conference have no relevant conflicts of interest to disclose. 9

Bethany W. Ibach, PharmD, BCPPS Assistant Professor Department of Pharmacy Practice

Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy Abilene, Texas

Chephra D. McKee, PharmD, BCPPS Assistant Professor of Pharmacy Practice Pediatrics Division Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy Abilene, Texas

Networking Reception ................................................................ 5:00 PM - 7:30 PM (Room: Grand Ballroom)

SUNDAY, OCTOBER 27, 2019

Registration ......................................................................... 7:00 AM - 1:00 PM (Room: Grand Ballroom Foyer) Continental Breakfast ................................................................. 7:00 AM - 9:00 AM (Room: Grand Ballroom) Concurrent Educational Sessions ......................................................................................... 8:00 AM - 9:00 AM

Texas Well-being: Promoting Well-being in Various Learning Environments (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-264-L04-P & 0156-0000-19-264-L04-T (0.1 CEUs) | Type: Application-based | Category: Foundational In this session, participants will learn about UT Austin Counseling Mental Health Center’s initiative to build collaborative relationships with faculty to support student mental health. They will learn how UT faculty have begun to create a learning community that decreases stressors, improves learning, builds student resilience, and helps students use specific wellness strategies and resources. Participants will walk away from this session having learned and practiced specific wellness strategies that they can take back and embed in their work environments. At the completion of this activity, the pharmacist and technician participant will be able to:

• Explain the importance of mental health and why using strategies to support wellness are important

• Identify different strategies to support well-being • Practice different strategies to support well-being

Thea Woodruff, PhD Lecturer & Well-Being in Learning Environments Coordinator UT Counseling and Mental Health Center Austin, Texas

All speakers participating in this conference have no relevant conflicts of interest to disclose. 10

Keeping it Legal: CBD Law Pharmacist Edition (Room: Hidalgo/Navarro) UAN: 0156-0000-19-265-L03-P & 0156-0000-19-265-L03-T (0.1 CEUs) | Type: Knowledge-based | Category: Advanced Clinical This 1-hour CE will focus on Texas pharmacy law as it relates to the prescribing and dispensing of CBD products. Attendants can expect to gain an understanding of both federal and state regulations regarding CBD products, as well as, pertinent pharmacologic properties of CBD based medications. In addition, this presentation will also discuss professional challenges as they relate to the prescribing and dispensing of CBD products. At the completion of this activity, the pharmacist & technician participant will be able to:

• Describe the pharmacology of cannabinoids (CBD) and their related compounds • Summarize federal CBD law and approval of Epidiolex • Explain CBD laws and regulations as they relate to the Texas Compassionate Use Program • Identify barriers to obtaining/dispensing Epidiolex and other CBD products as they relate to

current law Alexandra B. Ferrante, PharmD NICU/PICU Clinical Pharmacist Children’s Hospital of New Orleans New Orleans, Louisiana

Concurrent Educational Sessions ...................................................................................... 9:05 AM - 10:05 AM

Medication Safety Panel – Interventions to Reduce Pediatric Medication Errors (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-266-L05-P & 0156-0000-19-266-L05-T (0.1 CEUs) | Track: Knowledge-based | Category: Operational This session will serve to provide information for pharmacists and leaders with responsibility for medication safety oversight. The speakers will focus on several medication-related issues and initiatives from different health-systems that impact patient safety. The attendee will learn how to effectively select high-leverage strategies to sustain safety efforts within your organization. At the completion of this activity, the pharmacist and technician participant will be able to:

• Discuss the common causes of medication errors in Pediatrics • Discuss how computers and smart pumps can be our peripheral brain • Utilize the Institute of Medication Safety’s “Targeted Medication Safety Best Practices for

Hospitals” to identify and adopt medication strategies in a freestanding children’s hospital

Sara J.D. Bork, PharmD, MBA Assistant Director – Medication Safety and Education Texas Children’s Hospital Houston, Texas Kimberly L. Dinh, PharmD Clinical Pharmacy Specialist – Medication Use and Policy Texas Children’s Hospital Houston, Texas

All speakers participating in this conference have no relevant conflicts of interest to disclose. 11

Weng Man Lam, PharmD, MS, BCPS, BCPPS Pediatric Critical Care/Cardiovascular Clinical Pharmacist Specialist II Children's Memorial Hermann Hospital Memorial Hermann Texas Medical Center Houston, Texas Chi Pham-Peyton, PharmD, BCPPS Clinical Practice Specialist, Pediatric/NICU/Pain Management Memorial Hermann Hospital, Memorial City Houston, Texas

Staying Ahead of the Curve: AUC-guided Dosing of Vancomycin (Room: Hidalgo/Navarro) UAN: 0156-0000-19-267-L01-P & 0156-0000-19-267-L01-T (0.1 CEUs) | Type: Application-based | Category: Advanced Clinical Vancomycin is used for empiric therapy for suspected sepsis and is also considered the drug-of-choice for serious infections caused by methicillin-resistant Staphylococcus aureus (MRSA) in the pediatric population. The first consensus guideline endorsed by the American Society for Health-System Pharmacists, Infectious Diseases Society of America, and the Society for Infectious Diseases Pharmacists in 2009 outlined recommendations for vancomycin dosing and therapeutic monitoring in adults. Serum trough concentrations of 15-20 mg/L are utilized as a surrogate marker for optimal bactericidal activity based on in vivo pharmacokinetic and pharmacodynamic characteristics involving clinical efficacy, toxicity, and resistance. These guidelines do not address recommended dosing and monitoring recommendations for pediatric patients and there is little to no data on the safety and efficacy of targeted trough concentrations of 15-20 mg/L. Thus, a consensus statement and guideline endorsed by the American Society for Health-System Pharmacists, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, and the Society for Infectious Diseases Pharmacists in 2019, encourages vancomycin AUC/MICBMD ratio ≥ 400 as the currently accepted critical PK/PD index or “efficacy” target. With the near publication of these new guideline recommendations, it is both timely and essential to discuss the rationale for vancomycin AUC/MICBMD dosing, practical considerations for incorporating AUC/MICBMD dosing among pharmacist workflow and evaluate available Bayesian software programs. At the completion of this activity, the pharmacist and technician participant will be able to:

• Describe 2009 IDSA guideline recommendations related to vancomycin dosing and monitoring • Summarize 2019 IDSA draft guideline recommendations for AUC-guided vancomycin dosing • Evaluate practical considerations with incorporating AUC-guided dosing among pharmacist

workflow Sarah Kubes, PharmD, BCPS Clinical Assistant Professor and Pediatric Clinical Specialist Pharmacist UT College of Pharmacy and University Health Systems Austin, Texas Hillary Orr, PharmD Pediatric Clinical Pharmacy Specialist Pediatric/Cardiovascular Intensive Care Unit & Antimicrobial Stewardship Children’s Memorial Hermann Hospital Houston, Texas

All speakers participating in this conference have no relevant conflicts of interest to disclose. 12

Concurrent Educational Sessions ................................................................................... 10:10 AM - 11:10 AM Caffeine in Premature Infants: Too Much of a Good Thing? (Room: Bexar/Travis/Nueces) UAN: 0156-0000-19-268-L01-P & 0156-0000-19-268-L01-T (0.1 CEUs) | Type: Application-based | Category: Advanced Clinical Caffeine therapy has shown remarkable benefits beyond that of the short-term control of apneic events in premature infants. This has resulted in practitioners adopting changes in practice to initiate caffeine earlier with more aggressive dosing in an attempt to optimize the benefits in our most fragile patients. At the completion of this activity, the pharmacist participant will be able to:

• Describe the short and long-term benefits of caffeine therapy in premature infants. • Outline the current practices for caffeine treatment of preterm infants. • Discuss the impact of early initiation of caffeine treatment on outcomes. • Assess the evidence supporting higher caffeine dosages. • Develop a plan for discontinuation of caffeine and monitoring prior to discharge.

At the completion of this activity, the technician participant will be able to:

• Describe the short and long-term benefits of caffeine therapy in premature infants. • Outline the current practices for caffeine treatment of preterm infants. • Discuss the impact of early initiation of caffeine treatment on outcomes. • Review the evidence supporting higher caffeine dosages. • Assist in the development of a plan for discontinuation of caffeine and monitoring prior to

discharge.

Sherry Luedtke, PharmD, FPPAG Associate Professor of Pharmacy Practice Director of the Pediatric Specialty Residency Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy Lubbock, Texas

Lessons Learned for Pediatric Specialty Pharmacy (Room: Hidalgo/Navarro) UAN: 0156-0000-19-268-L01-P & 0156-0000-19-268-L01-T (0.1 CEUs) | Type: Application-based | Category: Operational Specialty pharmacy continues to grow as the market is expected to double over the next five years. Specialty patients represent less than 5% of all patients, but account for 35% of total healthcare spending. As hospitals are looking to begin or expand their specialty pharmacy services, it is important to understand that it must be an organizational initiative for success. From a pediatric specialty pharmacy perspective, there are some unique challenges that will be discussed around implementation, accreditation, and best practices. At the completion of this activity, the pharmacist and technician participant will be able to:

• Discuss key considerations for implementation of specialty pharmacy services in a pediatric hospital

• Recommend strategies for potential barriers of specialty pharmacy • Apply best practices for specialty pharmacy services

All speakers participating in this conference have no relevant conflicts of interest to disclose. 13

Amy Alonzo, RPh, BCPPS Specialty Pharmacist – Project Specialist Texas Children’s Hospital Houston, Texas Stephen J. Davis, PharmD, MS, FASHP Director, Health-System Strategy Shields Health Solutions Houston, Texas

Lunch with Exhibitors .............................................................. 11:15 AM - 1:00 PM (Room: Grand Ballroom) Texas Children's Hospital Facility Tours ............................................................................ 1:00 PM - 4:00 PM Separate ticketed event. See registration form for details.

Visit www.tshp.org/peds for full event details.

The Texas Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. These knowledge- and application-based continuing professional education programs may provide up to 14.0 contact hour

(1.4 CEUs) of continuing pharmacy education. This education has been designed with pharmacist and technician learners in mind. To receive credit for participation in these live educational sessions, you must claim your credit via the TSHP Education Portal (http://tshp.wcea.education/) no later than Monday, December 9, 2019. A live event “secret code” will be provided during the session, you must retain this code to claim your credit. A session evaluation must be completed through the online portal for credit to be issued. Access to an Internet enabled computer is required and use of the Mozilla Firefox browser is recommended. Accurate NABP profile and date of birth information is required for successful credit submission. It is the responsibility of the participant to ensure credit has been successfully transferred to their My CPE Monitor Profiles. TSHP is not responsible for loss of credit to participants that do not ensure credit issuance to their My CPE Monitor Profiles by Monday, December 9, 2019.