Drug-Drug Interactions in Elderly Individuals on Antidepressants: Patient care and health cost implications This program was originally presented as a live audioconference series beginning in October 2001. It was sponsored by the American Society of Consultant Pharmacists, and was accredited for 1.0 hour (0.1 CEUs) under ACPE Universal Program # 203-999-01-325-H01. If you participated in the live audioconference, you are not eligible to receive continuing pharmaceutical education credit through this program. This program was supported by an unrestricted grant from Pfizer Inc.

This program has been approved for 1.0 Contact hour of CPE. Normal certificate processing takes up to two weeks after successful completion of the program test.

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Target Audience
This virtual meeting will be of interest to consultant pharmacists who work with geriatric patients. Focusing on the results of formal studies and the use of case studies, this audioconference will assist pharmacists and nurses in understanding the frequency and potential risk of polypharmacy in elderly patients, particularly those on antidepressants, and the myriad ways in which DDIs can present clinically.

Learning Objectives On completion of this audioconference, the participant should be able to:
	Discuss and recognize the incidence of polypharmacy in patients on antidepressants.
	Recognize the ways that drug-drug interactions can present clinically.
	Understand and avoid drug-drug interactions involving cytochrome P450 enzymes in elderly persons taking antidepressants.
	Recognize that drug-drug interactions have health costs as well as healthcare consequences.

Program Outline
I.	Case Study I
II.	Role of Pharmacokinetics and Pharmacodynamics in DDIs
III.	Analogy to the Titanic
IV.	Polypharmacy: Reasons and Consequences
V.	Polypharmacy in Patients on Antidepressants
VI.	SSRIs and CYP Enzyme Inhibition
VII.	Case Study II
VIII.	Case Study III
IX.	Methods to Avoid DDIs
X.	Role of Generic Fluoxetine

Faculty Sheldon Preskorn, MD
	President and Medical Director
	Psychiatric Research Institute Professor and Chair Department of Psychiatry and Behavioral Sciences University of Kansas School of Medicine Wichita, KS

Sheldon Preskorn, MD has more than 20 years of drug development research experience at all levels (i.e., preclinical through Phase IV) and has been a principal investigator in more than 150 clinical trials, including every antidepressant marketed in the United States over the last decade. He is on the editorial boards for the Journal of Psychiatric Practice and the Journal of Clinical Psychopharmacology and has served as a reviewer for the National Institutes of Health, the National Institute of Mental Health, the National Science Foundation, and the Veterans Administration Merit Review. He has served on the Neuropsychopharmacology Advisory Board for the Food and Drug Administration and as a consultant to pharmaceutical regulatory agencies in the European Union, Japan, Australia, and Sweden. He has been a scientific reviewer for 34 basic science and medical journals and has been awarded continuous research funding since 1978. He has over 300 publications, including three best-selling books in clinical psychopharmacology and other books, peer-reviewed articles, book chapters, columns, abstracts, editorials, slide kits, and interviews. More information can be found at www.preskorn.com.

Disclosure
Dr. Preskorn reports research grants, speaker’s honoraria or consulting fees from Abbott Laboratories, Alza Pharmaceuticals, AstraZeneca, Aventis Pharmaceuticals Inc., Bayer Corporation Pharmaceutical Division, Boehringer Ingelheim Pharmaceuticals, Inc., Eisai Inc., Forest Laboratories, GlaxoSmithKline, Innapharma, Interneuron, Janssen Pharmaceutica Inc., Johnson & Johnson, Eli Lilly and Company, Lundbeck, Merck and Co., Inc., Ortho McNeil Pharmaceutical, Neurosearch, Neurogen, Nitromed, Novartis Pharmaceuticals Corporation, Organon Inc., Otsuka America Pharma, Inc., Pfizer Inc, Pharmacia & Upjohn, Inc., Roche Pharmaceuticals, Sandoz Pharmaceuticals Corporation, Sano, Schwartz Pharma, Inc., G.D. Searle & Co., Shire Pharmaceuticals, Solvay Pharmaceuticals, Inc., TAP Pharmaceuticals Inc., and Wyeth-Ayerst Laboratories.

The American Society of Consultant Pharmacists is approved by the American Council on Pharmaceutical Education as a provider of continuing pharmaceutical education. This program, ACPE#: 203-999-01-325-H01, is approved for 1.0 Contact Hour (0.1 CEU) and will be awarded based on satisfactory completion with a score of 70% or higher on the post-assessment examination. Program Date: October 2001. Reminder: If you attended the live audioconference, you are not eligible to receive continuing pharmaceutical education credit through this program. This program is valid through January 31, 2005.

Instructions

1. The first program screen will permit you to check for or download RealAudio's RealPlayer required to run this program.
2. Clicking on "start the program" on the next screen will begin the program.
3. Instructions for viewing the program and completing a CE post-test and evaluation will be found on the program’s opening screen. The program will require approximately one hour to complete.
4. A minimum score of 70% on the post-test is required for a CME or CE certificate.

This program was developed by Medical Communications Media, Inc. in conjunction with the American Society of Consultant Pharmacists and supported by an unrestricted grant from Pfizer Inc.