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Resident Seminar - December 16, 2021


 
                                                                  

LINK TO   EVALUATION >>

                                               PARKING REQUEST FORM  »                                                     MAP &     DIRECTIONS »
 
 
 
RESIDENT SEMINAR SCHEDULE
 
Wednesday, December 16, 2021
St. Louis College of Pharmacy at University of Health Sciences and Pharmacy in St. Louis
         Academic Research Building (ARB) and Virtually
 
 
 
ARB 304
ARB 305
ARB 336
ARB 354
ARB 355
Link to Teams Meeting
SESSION 1
1:00 – 1:45 pm
Sidney D'Amico, Pharm.D.
Use of Rifaximin in Hepatic Encephalopathy Prevention and Treatment
Kristin Hoff, Pharm.D.
Treatment Options in 2021 for Multidrug Resistant Acinetobacter
Ryan Moran, Pharm.D.
Gasping to Grasp Relief Inhalers in Asthma: ICS/Formoterol vs. Albuterol
Hanna Teer, Pharm.D.
Treatment Recommendations for Transthyretin Cardiac Amyloidosis
Diana Barajas, Pharm.D.
Use of DOACs for VTE Prophylaxis in Ambulatory Cancer Patients
 1:45 – 1:55 pm
Travel Time to accommodate movement between rooms
SESSION 2
1:55 – 2:40
Elizabeth Eastman, Pharm.D.
Myxedema Coma: Considerations for Thyroid Hormone Replacement
Lauren Hetzler, Pharm.D.
Antibiotic De-Escalation in Febrile Neutropenia
Ulyana Kucherepa, Pharm.D.
Extended Venous Thromboembolism Prophylaxis Beyond Hospitalization in Medically ill Patients
Beverly Anderson, Pharm.D.
Pharmacologic Strategies for Diuretic Resistance in Acute Decompensated Heart Failure
Ashley Lopez, Pharm.D.
Expanded Role of Rivaroxaban in Patients with Diabetes and Coronary Artery Disease
 2:40 – 2:50 pm
Travel Time to accommodate movement between rooms
SESSION 3
2:50 – 3:40 pm
Maria Gorla, Pharm.D.
Enteral Feeding in Critically Ill Patients
Molly Jorns, Pharm.D.
Oral Antibiotics for Step-down Therapy in Uncomplicated Gram-Negative Bacteremia
Leanne Allas, Pharm.D.
Two's Company, Three's a Crowd: Optimizing Therapy for People Living with HIV
 
Jesse Smith, Pharm.D.
Beta Blockade in Sepsis
Valerie Yuenger, Pharm.D.
Direct-Acting Oral Anticoagulants for the Treatment of Left Ventricular Thrombus
 
 
Please join us for the third and final Resident Seminar session of the 2021-2022 academic year. Presented by PGY1 and PGY2 residents from within the St. Louis area, this series focuses on current therapeutic topics in the practice of pharmacy. All sessions will be held in classrooms in the Academic & Research Building (ARB) on the third floor (see classroom numbers above), as well as virtually (see Teams links above).
 
Participants may earn a maximum possible 0.75 contact hour of CPE credit per session. The maximum possible credit that can be earned for this Resident Seminar is 2.25 contact hours. Participants must complete an evaluation (see link above) to receive credit.

Click here for a printable copy of the schedule


REGISTRATION: To register for the LIVE Resident Seminar presentations, click here>>>. There is no need to register for the virtual presenations. Please use the links within the table above to connect to the VIRTUAL presentations. Special note, this event has multiple concurrent sessions.
 
Due to a limited number of live available classroom spaces, a maximum of 22 people are allowed per classroom. Virtual attendance is limitless.

Registration is free but is required in advance for the LIVE presentations. Due to limited space, only those participants who register for the LIVE session before 5:00 PM on Friday, December 10, 2021 will be able to request parking access on campus.

PARKING: To request parking, please first register for your desired LIVE sessions. Then, complete the Parking Request Form using the link above, or complete your parking request by clicking here>>>. If you do not request parking on our campus, or if you do not submit your request by the deadline, you will be re-directed upon arrival.

HANDOUTS: Participants attending the LIVE (on-campus) sessions will be provided paper copies of handouts within the classrooms. Virtual attendees can access the handouts in the conversation feature within Teams. Copies of PowerPoint slides are not provided.

ATTENDANCE: All live participants will be required to sign in on the paper sheets, located within each room. Paper sign-in sheets will be reconciled against completed evaluations. Attendance for the virtual sessions will be captured once a participant joins the session and will be reconciled with completed evaluations. Any sessions that you did not attend will be removed from your account within two weeks following the seminars.

CPE CREDIT: Immediately following Resident Seminar, participants should complete an evaluation for EACH presentation attended (3 maximum) by clicking here>>>. Participants will have one week after attending the session to complete the evaluation. The CPE Administrator will submit each participant’s NABP number and date of birth combination to CPE Monitor for continuing education credit, no later than two weeks after the live and virtual presentations. Only ONE session may be claimed for each of the three blocks. If multiple concurrent sessions are claimed, or if a session is claimed that is not reflected on the paper sign or the attendance roster within Microsoft Teams Meeting, the offending participant forfeits CE credit.
 
It is recommended that participants log on and review the information under "My Account" prior to completing evaluations. The NABP ePID and date of birth fields must be accurate for credit reporting to occur. Participants are encouraged to check their NABP eProfiles for receipt of credit within two weeks of submitting their evaluation(s). If a participant notices an error in credit on their NABP e-profile, they are encouraged to contact Nicole Fields at Nicole.Fields@uhsp.edu soon as possible. To best comply with ACPE's CE credit reporting policy, the University of Health Sciences and Pharmacy in St. Louis is unable, for any reason, to award or correct CE credit if more than 60 days have passed from the event.
 
After one week, evaluations will close and CPE credit may no longer be claimed. If the deadline is missed or if a CE credit correction must be issued, an additional fee may be incurred for late submission - please see our policy, located on the FAQ page for details. Evaluations close December 23, 2021 at 11:59 PM (CST).

SPECIAL ACCOMMODATIONS
Attendees of all abilities are welcome to participate. If you require reasonable accommodations, please notify Nicole Fields via email at Nicole.Fields@uhsp.edu in advance so that she may secure resources as soon as possible. Every effort will be made to make accommodations where necessary.
 

Date: Dec 16, 2021 01:00 PM - 03:40 PM

Fee

$0.00

CE Hours

11.25

Activity Type

  • Knowledge

Target Audience(s)

  • Pharmacists

Accreditation(s)

Accreditation Council for Pharmacy Education
St. Louis College of Pharmacy at the University of Health Sciences and Pharmacy in St. Louis is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. To learn more about the specific program information, including universal activity numbers (UAN's) and learning objectives, please expand the modules below. Following successful completion of an evaluation, CE credit will be automatically reported to NABP through the CPE Monitor system, using the NABP ePID numbers and date of birth (MMDD) stored in participants' user profiles. Follow this link to learn more about CPE Monitor and the credit reporting process »  Participants are responsible for insuring receipt of credit; no credit can be corrected or awarded if more than 60 days have passed from the date of the event or if the home study is expired.
 
It is the policy of St. Louis College of Pharmacy at the University of Health Sciences and Pharmacy in St. Louis, to ensure balance, independence, objectivity and scientific rigor in all its educational programs. All faculty participating in this program are expected to disclose to the program audience any real or apparent conflicts of interest related to the content of the presentation.

 

 

 

Hepatic encephalopathy is brain dysfunction caused by hepatic insufficiency and or portosystemic shunting. Treatment and prevention of hepatic encephalopathy is critical as hepatic encephalopathy alters psychometric tests oriented toward attention, working memory, psychomotor speed, and visuospatial ability, as well as electrophysiological and other functional brain measures. All episodes of overt hepatic encephalopathy (OHE), whether spontaneous or precipitated, should be actively treated. Current AASLD Guidelines recommend lactulose as the first line treatment with rifaximin being an effective add-on therapy to lactulose for subsequent episodes. Guidelines currently do not have recommendations for primary prevention of hepatic encephalopathy with either lactulose or rifaximin. For secondary prevention, lactulose is recommended for prevention of recurrent episodes, whereas rifaximin is recommended as an effective add-on therapy after the second episode.  Since these guidelines were published in 2014, more data have been published that should be further evaluated when determining treatment options for hepatic encephalopathy.  This presentation will focus on more recently published trials on the role of rifaximin for both prevention and treatment of hepatic encephalopathy.

Objectives

  • Evaluate the benefit of rifaximin use in the treatment of hepatic encephalopathy
  • Identify patients who would benefit from rifaximin in the prevention of hepatic encephalopathy

Speaker(s)/Author(s)

Sidney D'Amico, Pharm.D.

Activity Number

0033-0000-21-074-L01-P
Date: 12/16/21
Time: 01:00 PM - 01:45 PM

CE Hours

0.75

Location

ARB 304 and Virtually
 

 

Acinetobacter consists of a group of gram-negative bacteria that are ubiquitously found in the environment in soil and water. Acinetobacter baumannii accounts for most Acinetobacter infections in humans and causes a variety of infections including pneumonia, bacteremia, meningitis, urinary tract infection, and skin and soft tissue infection. In healthcare settings, it is often spread from contaminated surfaces or equipment and can survive for extended periods on environmental surfaces. Acinetobacter poses little risk to healthy individuals but can cause significant morbidity and mortality in immunocompromised patients. Acinetobacter displays a high amount of antibiotic resistance with the majority of isolates demonstrating multidrug resistance. The mechanisms of resistance include enzymatic inactivation, reduced antibiotic entry into the bacteria, and mutations causing alteration of cell function. The emergence of strains resistant to first line therapies such as ampicillin/sulbactam, carbapenems, and cefepime is increasing necessitating the need for alternative drug treatment. A review of the literature evaluating newer antimicrobial agents for the treatment of multidrug resistant Acinetobacter bauannii will be conducted.

Objectives

  • Identify current treatment options for carbapenem resistant Acinetobacter infections
  • Summarize the current data behind eravacycline and cefiderocol for the treatment of Acinetobacter infection
  • Identify place in therapy for new antimicrobial agents for the treatment of multidrug resistant Acinetobacter infection

Speaker(s)/Author(s)

Kristin Hoff, Pharm.D.

Activity Number

0033-0000-21-064-L01-P
Date: 11/17/21
Time: 01:00 PM - 01:45 PM

CE Hours

0.75

Location

ARB 305 and Virtually
 

 

Albuterol had been the mainstay of relief inhaler therapy in asthma for years. Recent changes to the Global Initiative for Asthma (GINA) guidelines recommend ICS/formoterol over albuterol. This change has been somewhat controversial among practitioners with many questioning this recommendation. Many patients with asthma still use albuterol as their relief inhaler. Additional education in this area is needed to allow for practitioners to make their own informed decisions for their patients regarding relief inhalers. This seminar aims to review the current guidelines and the literature relating to this guideline change.

Objectives

  • Identify a preferred relief inhaler for patients with asthma according to the most recent GINA guidelines
  • Summarize the data supporting ICS/formoterol as the preferred relief inhaler in the most recent GINA guidelines

Speaker(s)/Author(s)

Ryan Moran, Pharm.D.

Activity Number

0033-0000-21-067-L01-P
Date: 12/16/21
Time: 01:00 PM - 01:45 PM

CE Hours

0.75

Location

ARB 336 and Virtually
 

 

The identification, diagnosis, and treatment recommendations for transthyretin cardiac amyloidosis (amyloid cardiomypathy) will be discussed at length. There will be a general overview of cardiac amyloidosis, specifically regarding how to identify patients at risk, the diagnostic process, and treatment strategies. The primary focus of the presentation will be discussion regarding novel treatments for cardiac amyloidosis and an evaluation of available literature for these treatment agents will be presented. Questions incorporating materials discussed during the presetnation will be used as teaching materials interspersed throughout the topic presentation.

Objectives

  • Define cardiac amyloidosis
  • Identify patients at risk for cardiac amyloidosis
  • Describe appropriate strategies for diagnosing and treating cardiac amyloidosisDetermine what agent is the most appropriate treatment regimen for a patient with cardiac amyloidosis
  • Determine what agent is the most appropriate treatment regimen for a patient with cardiac amyloidosis

Speaker(s)/Author(s)

Hanna Teer, Pharm.D.

Activity Number

0033-0000-21-077-L01-P
Date: 12/16/21
Time: 01:00 PM - 01:45 PM

CE Hours

0.75

Location

ARB 354 and Virtually
 

 

Thromboembolic events are a common complication for patients being treated for active malignancy. Use of chemical thromboprophylaxis in this patient population has historically been limited to patients being treated in the inpatient setting, either for acute illness or as post-surgical prophylaxis. Newer research has determined that some high-risk patients undergoing cancer treatment in the ambulatory setting would benefit from thromboprophylaxis as well. The use of rivaroxaban and apixaban have recently been investigated as thromboprophylaxis options in this patient population due to their convenience of oral administration compared to the parenteral agents traditionally used. Cancer patients with brain metastasis or primary brain cancers are known to be both at an increased risk of both thromboembolic events and bleeding. There is not direct guidance about utilization of thromboprophylaxis in this population stated in current guidelines. This presentation will review the literature that lead to the addition of rivaroxaban and apixaban to the guidelines as thromboprophylaxis options in ambulatory cancer patients and examine literature to help direct us on appropriate thromboprophylaxis in patients with brain metastasis or primary brain cancers.

Objectives

  • Identify specific risk factors in ambulatory patients with active malignancy that increase the risk of developing cancer-associated venous thromboembolism
  • Describe current literature that supports the use of direct oral anticoagulants as thromboprophylaxis options for ambulatory patients with active malignancy
  • Explain limitations of the use of direct oral anticoagulants for thromboprophylaxis in ambulatory patients with active malignancy

Speaker(s)/Author(s)

Diana Barajas, Pharm.D.

Activity Number

0033-0000-21-063-L01-p
Date: 12/16/21
Time: 01:00 PM - 01:45 PM

CE Hours

0.75

Location

ARB 355 and Virtually
 

 

Myxedema coma is a rare condition requiring emergent recognition and treatment, This program will describe the management of myxedema coma specifically as it related to thyroid hormone replacement through a review of treatment guidelines and pertinent primary literature.

Objectives

  • Describe the clinical presentation of a patient with myxedema coma
  • Identify the components of a treatment regimen for a patient with myxedema coma
  • Summarize the data available regarding the use of thyroid hormones in the treatment patients with myxedema coma

Speaker(s)/Author(s)

Elizabeth Eastman, Pharm.D.

Activity Number

0033-0000-21-070-L01-P
Date: 12/16/21
Time: 01:55 PM - 02:40 PM

CE Hours

0.75

Location

ARB 304 and Virtually
 

 

Febrile neutropenia is a serious complication experienced by many patients receiving chemotherapy. Patients with febrile neutropenia are at a high risk for morbidity and mortality from infections due to the lack of the body's natural defense mechanisms. Current guidelines recommend empiric therapy with broad-spectrum antibiotics with antipseudomonal activity. However, the three current guidelines differ in their recommendations for de-escalation and discontinuation of antimicrobials prior to ANC recovery. Conventionally, broad-spectrum antibiotics are continued until ANC recovery regardless of culture results. Current guidelines address the possibility of de-escalating based on culture results, but differ in their recommendations. There is recent evidence on de-escalating to fluoroquinolone prophylaxis in neutropenic patients with fever of unknown origin prior to ANC recovery. This presentation will evaluate the literature and attempt to answer the question of whether this practice appears to be safe.

Objectives

  • Describe the conventional approach to treating febrile neutropenia
  • Compare the three current guidelines for febrile neutropenia
  • Summarize the evidence for de-escalating to fluoroquinolone prophylaxis in febrile neutropenia before neutrophil recovery

Speaker(s)/Author(s)

Lauren Hetzler, Pharm.D.

Activity Number

0033-0000-21-071-L01-P
Date: 12/16/21
Time: 01:55 PM - 02:40 PM

CE Hours

0.75

Location

ARB 305 and Virtually
 

 

Approximately 1-2% of recently hospitalized medically ill patients will develop symptomatic DVT or PE within 6 weeks of discharge after in-hospital VTE prophylaxis is terminated. [5] Extended thromboprophylaxis given to medically ill patients following a hospitalization remains a controversial topic among medical providers. Current guidelines do not recommend extended VTE prophylaxis beyond hospitalization in medically ill patients. However, the guidelines acknowledge the need for further research and developing an individualized algorithm aiming to identify medically ill patients who would benefit from extended VTE prophylaxis beyond hospitalization. An individualized approach to determine who qualifies for extended VTE prophylaxis is warranted. The goal of the program is to provide an overview of recent literature evaluating the use of extended VTE prophylaxis beyond hospitalization, and to apply the findings to develop an example algorithm to assist with clinical decision making.

Objectives

  • Discuss major venous thromboembolism risk stratifications tools
  • Discuss major clinical trials representing the efficacy and safety associated with the use of extended venous thromboembolism prophylaxis in medically-ill patients beyond hospitalization
  • Select patients who might qualify for extended venous thromboembolism prophylaxis beyond hospitalization

Speaker(s)/Author(s)

Ulyana Kucherepa, Pharm.D.

Activity Number

0033-0000-21-065-L01-P
Date: 12/16/21
Time: 01:55 PM - 02:40 PM

CE Hours

0.75

Location

ARB 336 and Virtually
 

 

This continuing education seminar will examine the use of pharmacologic agents to augment diuresis in patients with acute decompensated heart failure (ADHF). It will begin with an overview of epidemiology and presentation of patients with ADHF and an identification of patients with diuretic resistance. It will then use literature to select appropriate dosing strategies for loop diuretics. At this point, the presentation will review how to address mechanisms of diuretic resistance and specifically examine the use of spironolactone, thiazide and thiazide-like diuretics, and tolvaptan in patients with ADHF. Evaluation of audience comprehension will be addressed throughout the presentation in the form of multiple-choice questions. 

Objectives

  • Describe the possible mechanisms of diuretic resistance
  • Compare and contrast the efficacy and safety of thiazide diuretics and arginine vasopressin (AVP) antagonists
  • Select an appropriate treatment regimen for a patient with acute decompensated heart failure (ADHF) with diuretic resistance

Speaker(s)/Author(s)

Beverly Anderson, Pharm.D.

Activity Number

0033-0000-21-075-L01-P
Date: 12/16/21
Time: 01:55 PM - 02:40 PM

CE Hours

0.75

Location

ARB 354 and Virtually
 

 

Cardiovascular disease is the leading cause of mortality in patients with diabetes mellitus. While antiplatelet therapy is currently utilized in this patient population to help prevent future cardiovascular (CV) events, these agents have no role in thrombin inhibition which may also precipitate CV events. Recent studies have evaluated the addition of a low-dose anticoagulant to antiplatelet therapy, and current guidelines have incorporated this strategy as a consideration in patients deemed to be at low bleeding risk. This presentation will address emerging evidence regarding the potential use of dual pathway antithrombotic therapy with aspirin in combination with a reduced-dose anticoagulant and stratify clinical benefit.

Objectives

  • Compare and contrast the efficacy and safety outcomes associated with the addition of low dose rivaroxaban to aspirin in patients with diabetes and stable coronary artery disease
  • Summarize the mechanism contributing to the increased thrombotic environment in patients with diabetes
  • Identify patients that would potentially benefit from dual pathway inhibition therapy with low dose rivaroxaban plus aspirin

Speaker(s)/Author(s)

Ashley Lopez, Pharm.D.

Activity Number

0033-0000-21-066-L01-P
Date: 12/16/21
Time: 01:55 PM - 02:40 PM

CE Hours

0.75

Location

ARB 355 and Virtually
 

 

This presentation will aim to address the clinical controversy surrounding the use of enteral nutrition in critically ill patients receiving vasopressors. After presenting the need for nutrition in critically ill patients, this presentation will recount anecdotal data against the use of enteral nutrition in critically ill patients, describe the demonstrated benefits of early enteral nutrition, and then examine current literature suggesting that early enteral nutrition is safe and effective in critically ill patients receiving vasoactive medications.

Objectives

  • Describe why enteral nutrition was historically avoided in critically ill patients
  • Identify which vasopressors impact the use of enteral nutrition in critically ill patients
  • Distinguish patients who may be candidates for early enteral nutrition

Speaker(s)/Author(s)

Maria Gorla, Pharm.D.

Activity Number

0033-0000-21-073-L01-P
Date: 12/16/21
Time: 02:50 PM - 03:40 PM

CE Hours

0.75

Location

ARB 304 and Virtually
 

 

This continuing education seminar will examine the role of step-down therapy to oral antibiotics in patients with gram-negative bacteremia. The presentation will begin by describing the epidemiology of and risk factors for gram-negative bacteremia. Next, common pathogens and principles of treatment will be reviewed, including several trials pertaining to seven versus fourteen days of antimicrobial therapy. Available literature pertaining to step-down in gram-negative bacteremia will be summarized followed by other pertinent retrospective case studies which include patients with bactermia due to a variety of sources. The presentation will then move into a review and analysis of a trial comparing fluoroquinolones to beta lactams as oral step-down agents as well as a large meta-analysis. The presentation will conclude with evaluation of how step-down to oral antibiotics fits into treatment algorithms for patients with gram-negative bacteremia.

Objectives

  • Identify common pathogens associated with gram-negative bacteremia
  • Distinguish between high, moderate, and low bioavailability antibiotics
  • Select patients who are candidates for oral antibiotic step-down therapy in uncomplicated gram-negative bacteremia

Speaker(s)/Author(s)

Molly Jorns, Pharm.D.

Activity Number

0033-0000-21-068-L01-P
Date: 12/16/21
Time: 02:50 PM - 03:40 PM

CE Hours

0.75

Location

ARB 305 and Virtually
 

 

This presentation will review the use of 2 drug antiretroviral regimens as treatment optimization for persons living with HIV currently maintained on traditional 3 drug antiretroviral regimens. Topics to be discussed include: currently available antiretroviral drug combinations to treat persons with HIV, benefits of the switch from the traditional 3-drug antiretroviral regimens to 2-drug antiretroviral regimens, and current switch clinical studies. By the end of this presentation pharmacists will be able to identify patients that may be eligible for a switch to a 2-drug antiretroviral regimen.

Objectives

  • Identify when the switch from a traditional 3 drug antiretroviral therapy to 2 drug antiretroviral therapy is appropriate
  • Compare the use of 2 drug antiretroviral therapy regimens to the traditional 3 drug antiretroviral therapy regimens to optimize treatment for persons living with HIV

Speaker(s)/Author(s)

Leanne Allas, Pharm.D.

Activity Number

0033-0000-21-069-L01-P
Date: 12/16/21
Time: 02:50 PM - 03:40 PM

CE Hours

0.75

Location

ARB 336 and Virtually
 

 

This seminar will examine the specific mechanisms in which sepsis and excessive sympathetic stimulation can result in cardiac dysfunction and discuss the potential role ultrashort beta-blockers can have to overcome these negative effects.  In addition, the session will focus on analyzing recent literature examining beta-blocker therapy in sepsis to identify patient characteristics that may see benefits or harms in receiving beta-blocker therapy.

Objectives

  • Describe the mechanisms in which sepsis can induce cardiac dysfunction
  • Summarize recent literature evaluating beta-blocker therapy in patients with sepsis
  • Identify patient specific characteristics that may see the most benefit or harm from starting beta-blocker therapy in sepsis

Speaker(s)/Author(s)

Jesse Smith, Pharm.D.

Activity Number

0033-0000-21-076-L01-P
Date: 12/16/21
Time: 02:50 PM - 03:40 PM

CE Hours

0.75

Location

ARB 354 and Virtually
 

 

Left ventricular thrombus (LVT) is a common occurrence following acute myocardial infarction and as a result of both ischemic and nonischemic cardiomyopathies. LVT is often complicated by stroke and systemic embolism, for which the treatment with anticoagulation to prevent such events is indicated. The current guideline-recommended treatment is oral anticoagulation with warfarin; however, most of the relevant guidelines were published prior to the recent data evaluating the efficacy and safety of direct-acting oral anticoagulants (DOACs) in this setting. DOACs are an attractive alternative treatment approach to warfarin for many patients, considering their more predictable dosing, less frequent monitoring, fewer drug-drug and drug-food interactions, and established safety and efficacy for several other indications. This presentation will use the existing literature evaluating DOAC use for the treatment of LVT to determine the appropriateness of such therapy and in which patients it should be considered.

Objectives

  • Summarize existing literature for the use of DOACs for the treatment of LVT
  • Identify the role of DOACs for the treatment of LVT

Speaker(s)/Author(s)

Valerie Yuenger, Pharm.D.

Activity Number

0033-0000-21-072-L01-P
Date: 12/16/21
Time: 02:50 PM - 03:40 PM

CE Hours

0.75

Location

ARB 355 and Virtually