In this talk, participants will receive an overview of the various medications that can be used to treat mental distress. The speaker will review the history of psychopharmacology, beginning with the use of anxiety medications, then hypnotics. A history of antidepressants, mood stabilizers, and antipsychotics will follow, and the speaker will end with a brief discussion of stimulants.

This talk will address common questions asked about patients with chronic kidney disease (CKD). What is a good blood pressure target for my patient? How should I use ACE-inhibitors and angiotensin receptor blockers (ARBs) in CKD? Or evaluate for secondary hypertension? What about new treatments like sodium bicarbonate and SGLT2 inhibitors? As well as answering these questions, the faculty will discuss the goals of the executive order from the Department of Health and Human Services signed in July 2019: reducing the risk of kidney failure, improving access and quality of person-centered treatment options, and increasing access to transplants.

Using Choosing Wisely, AAP, and CDC recommendations as a foundation, the faculty will review the evidence-based guidelines for the following topics: diagnosis/management of upper respiratory infections (e.g., otitis media), the efficacy of PPI/H2B in young children, the new updates in blood pressure screening, universal HIV screening in adolescents, and mental health tools that assist in screening for depression, anxiety, and ADHD.

Infectious diseases syndromes are common in primary care practices. However, staying current with relevant literature that may influence appropriate evaluation and treatment of patients with these syndromes can be difficult, given the volumes of applicable articles and diversity of journals publishing these reports. This session will present some common infectious disease scenarios and provide crucial literature updates. You will learn about how responding to histories of penicillin allergy may result in adverse patient outcomes, the proper timing of influenza vaccination, the influence of substance abuse on risk medication adherence and infectious diseases risk, the appropriate evaluation of patients with suspected cellulitis syndromes, and the role of preoperative urine screening.

In the U.S., about 15.1 million people have an alcohol use disorder and about 4.8 million misuse opioids. This session focuses on the pharmacotherapy of alcohol and opioid use disorders. The faculty will describe and contrast naltrexone and acamprosate treatments for alcohol use disorder and discuss the use of buprenorphine/naloxone to treat opioid use disorder.

Shoulder and knee pain are very common conditions in primary care, but many providers are not familiar or comfortable with the elements of the history and physical exam hallmarks that are most helpful in making the correct diagnosis. In this talk, the faculty will review historical features, physical exam maneuvers, and differential diagnosis for shoulder and knee pain in adult patients. Emphasis will be on the physical exam, and physical exam maneuvers will be demonstrated. We will also discuss initial office-based treatment for the common causes of shoulder and knee pain, including indications for orthopedics referral.

Providing safe and effective pain control can be achieved despite the serious public health crisis of the opioid overdose and misuse epidemic currently affecting the United States and other countries. This talk will review the evolution of the present-day opioid epidemic to better understand current risks. Terminology associated with addiction, currently referred to as substance use disorder, will be defined. Assessment of pain is imperative, with a shift away from intensity to functional ability. Risk factors for misuse must also be assessed. These findings inform the treatment regimen, including whether opioids are indicated, and if so, what mitigating strategies must be implicated to reduce the risk of misuse. Techniques such as harm reduction, weaning and safe handling will be addressed.

Over the past 20 years, there has been push back from patients about vaccines. This has been driven by concerns about vaccine safety promoted by the media, celebrities, and (now retracted) scientific reviews. As a result, there have been numerous outbreaks of rare, vaccine preventable infections. There has been a resurgence of mumps, pertussis and respiratory syncytial virus infections. Currently the United States is facing growing numbers of measles cases. These infections put the most vulnerable patients at risk of serious morbidity and mortality. All clinicians should understand what is true and untrue about the anti-vaccine controversy and how to discuss the benefits and risks of vaccination with their patients. Clinicians should also be aware of the most updated adult vaccine recommendations by the CDC and ACIP and ensure their patients are vaccinated properly. Given the recent resurgence of measles, clinicians should also be able to recognize a case of measles, how to diagnose and care for patients with suspected measles, and how to report a case to their local public health department.

This talk will provide an opportunity for the learner to (anonymously) test his/her knowledge in the management of people with type 2 diabetes using cases and an ARS. The cases will also be used to illustrate the pathophysiology of type 2 diabetes and provide an opportunity for developing a practical approach to treating people with type 2 diabetes, utilizing the commonest and newest medications available. The cases will also help the learners use medications safely and understand advantages and disadvantages, and common side effects of each class of medication. Finally a practical approach to the initiation and intensification of basal insulin will be covered.

e-Cigarettes were 1st introduced to the US market in 2007, essentially to help smokers stop smoking tobacco-based cigarettes. There is some evidence that, for some adults, it may be beneficial to assist with smoking cessation. However, the use of e-Cigarettes and vaping (referred to as ENDS – electronic nicotine delivery systems), has increased significantly, specifically in the US teen population. The FDA and AAP have addressed the concerns surrounding e-Cigarettes and vaping in both regulations and policy statements. Join us as we discuss the latest evidence, potential benefits, and public health concerns regarding e-Cigarettes and vaping.

Pri-Med's new weekly CME/CE web series, Primary Care Pulse, features live conversations about timely topics and concerns facing primary care clinicians.