This activity was supported in part by an educational grant from Abbott Laboratories
Jointly sponsored by Mount Sinai School of Medicine and ASi
All rights reserved. No part of this activity may be used or reproduced in any manner
whatsoever without written permission.
Pancreatic exocrine insufficiency (PEI) is not a disease but a condition that can
result from a number of diseases as well as common surgical procedures. It can cause
loss of the pancreatic parenchyma, which leads to insufficient secretion of enzymes.
Symptoms of PEI can range from mild to severe and can cause malabsorption and malnutrition
and may significantly impact morbidity and mortality. Pancreatic enzyme replacement
therapy (PERT) medications have the potential to cause serious adverse effects as
well as significant drug-drug interactions. Furthermore, they are not equivalent
and cannot be interchanged. It is critical that healthcare providers understand
the seriousness of this condition, be able to properly diagnose and treat their
patients with PEI, and avoid inducing adverse effects. Through a partnership with
The National Pancreas Foundation, cutting-edge educational technology, and expert
faculty, we have created online patient simulations that will allow participants
to interact with sample patients and receive immediate feedback.
The goal of this activity is to recognize various etiologies of PEI as well as the
complex dosing and significant adverse effects of PERT-related drug-drug interactions.
This educational activity has been developed for gastroenterologists, internists,
and primary care physicians involved in the care and management of patients with
PEI. No prerequisites required.
At the conclusion of this activity, participants will demonstrate the ability to:
the pathophysiology of PEI and conditions that place
patients at risk for developing PEI.
current perspectives on appropriate dosing of pancreatic
enzyme replacement therapies.
potential adverse effects and drug interactions associated
with pancreatic enzyme replacement therapies and methods of determining proper dosing
to reduce these adverse effects.
the relationship between pulmonary and gastrointestinal
involvement in patients with PEI.
techniques that improve multiprofessional communication
to maintain continuity of care and relay treatment expectations to patients with
This activity has been planned and implemented in accordance with the Essential
Areas and Policies of the Accreditation Council for Continuing Medical Education
through the joint sponsorship of Mount Sinai School of Medicine and Advanced Studies
Medicine. The Mount Sinai School of Medicine is accredited by the ACCME
to provide continuing medical education for physicians.
CREDIT DESIGNATION STATEMENT
The Mount Sinai School of Medicine designates this enduring material activity for
a maximum of 1.5 AMA PRA Category 1 Credit(s)™
. Physicians should claim only
the credit commensurate with the extent of their participation in the activity.
This Continuing Medical Education (CME) activity was prepared in accordance with
the ACCME Essentials and Standards for Commercial Support.
The estimated time to complete this activity: 1.5 hours.
Release date: July 25, 2012
Expiration date: July 25, 2013
Peer Reviewed: Timothy B. Gardner, MD. Peer Review Date: March 13, 2012.
The opinions and recommendations expressed by faculty and other experts whose input
is included in this program are their own. This enduring material is produced for
educational purposes only. Use of the Mount Sinai School of Medicine name implies
review of educational format, design, and approach. Please review the complete prescribing
information of specific drugs or combinations of drugs, including indications, contraindications,
warnings, and adverse effects, before administering pharmacologic therapy to patients.
There is no fee for this activity.
Christopher J. DiMaio, MD (Course Director)
Director of Therapeutic Endoscopy
Program Director, Advanced Endoscopy Fellowship
Assistant Professor of Medicine
Division of Gastroenterology
Mount Sinai School of Medicine
New York, New York
Dr. DiMaio reports having no relevant financial relationships.
Andres Gelrud, MD, MMSc
Associate Professor of Medicine
Director, Therapeutic Endoscopy
Medical Director, Total Pancreatectomy/Islet Autotransplantation
Division of Gastroenterology, Hepatology, and Nutrition
University of Pittsburgh Medical Center
Dr. Gelrud reports having no relevant financial relationships.
Bechien U. Wu, MD, MPH
Director of Pancreatic Disorders
Kaiser Permanente Los Angeles Medical Center
Los Angeles, California
Dr. Wu reports having no relevant financial relationships.
Timothy B. Gardner, MD
Director, Pancreatic Disorders
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire
FULL DISCLOSURE POLICY AFFECTING CME ACTIVITIES
It is the policy of Mount Sinai School of Medicine to ensure objectivity, balance,
independence, transparency, and scientific rigor in all CME-sponsored educational
activities. All faculty participating in the planning or implementation of a sponsored
activity are expected to disclose to the audience any relevant financial relationships
and to assist in resolving any conflict of interest that may arise from the relationship.
Presenters must also make a meaningful disclosure to the audience of their discussions
of unlabeled or unapproved drugs or devices.
OFF-LABEL PRODUCT DISCUSSION
No faculty intend to discuss unlabeled use of drugs.
All rights reserved. No part of this syllabus
may be used or reproduced in any manner whatsoever without written permission except
in the case of brief quotations embodied in articles or reviews.
M protects the privacy of personal and
other information regarding participants and educational collaborators. ASi
will not release personally identifiable information to a third party without the
individual’s consent, except such information as is required for reporting purposes
to the ACCME.
M maintains physical, electronic, and procedural safeguards that comply
with federal regulations to protect against the loss, misuse of alteration of information
that we have collected from you.
If you have questions about this internet
CME/CE activity, please contact at 908-253-9001 or
or Mount Sinai School of Medicine at
HARDWARE AND SOFTWARE REQUIREMENTS
Pentium 800 processor or greater, Windows 98/NT/200/XP or Mac OS 9/X or later, Microsoft
Internet Explorer, Safari, Firefox, Windows Media Player 9.0 or later Flash player,
128 MB of RAM Monitor settings: High color at 800 x 600 pixels, sound card and speakers,
Adobe Acrobat Reader.
Participants must take the pre-test, view all 3 web-based simulation modules, and
complete the post-test and evaluation to receive CME credit. A score of at least
70% is required to successfully complete this activity. A certificate can be printed
out immediately after the participant successfully completes this activity.
Bechien U. Wu, MD, MPH
Andres Gelrud, MD, MMSc
Pancreatic Neoplasm and Pancreatic Surgery
Christopher J. DiMaio, MD