SC AHEC family practice residency program graduates: where are they, who do they serve, and what services do they provide?

The findings of this study of family practice program graduates are consistent with the mission of SC AHEC "to educate and retain primary health care providers." The graduates of these programs are providing a variety of medical services to a diverse patient population in South Carolina and surrounding states.

Antidepressants: update on new agents and indications.

A number of antidepressants have emerged in the U.S. market in the past two decades. Selective serotonin reuptake inhibitors have become the drugs of choice in the treatment of depression, and they are also effective in the treatment of obsessive-compulsive disorder, panic disorder, and social phobia. New indications for selective serotonin reuptake inhibitors include post-traumatic stress disorder, premenstrual dysphoric disorder, and generalized anxiety disorder. Extended-release venlafaxine has recently been approved by the U.S. Food and Drug Administration for the treatment of generalized anxiety disorder. Mirtazapine, which is unrelated to the selective serotonin reuptake inhibitors, is unique in its action--stimulating the release of norepinephrine and serotonin. The choice of antidepressant drug depends on the agent's pharmacologic profile, secondary actions, and tolerability. Sexual dysfunction related to the use of antidepressants may be addressed by reducing the dosage, switching to another agent, or adding another drug to overcome the sexual side effects. Augmentation with lithium or triiodothyronine may be useful in patients who are partially or totally resistant to antidepressant treatment. Finally, tapering antidepressant medication may help to avoid discontinuation syndrome or antidepressant withdrawal.

The clinical pharmacist as a preceptor in a family practice residency training program.

BACKGROUND: According to a recent survey, 27% of 579 family practice residency programs in the United States employ a full-time clinical pharmacist. The majority of pharmacists' time is spent teaching, usually at the point of care either on inpatient rounds or precepting in the outpatient clinic. This paper describes the precepting activity of a full-time clinical pharmacist in a community-based family practice residency training program. METHODS: A computer program written in Microsoft Access captured the following data on each pharmacist-physician encounter: date, time, requestor, topic, therapeutic category, type of question, summary of question and answer, resources used to answer the question, and time spent answering the question. The database was updated daily to include all encounters. RESULTS: Between February 1, 1999, and January 31, 2001, we documented 2,260 precepting encounters. Almost half of the questions related to general pharmacotherapeutic management of chronic or acute diseases. The most common therapeutic categories encompassed cardiovascular, psychiatric, infectious disease, and neurologic disorders. Seventy-six percent of questions were answered using clinical knowledge and experience, while 24% were based on published resources. CONCLUSIONS: Based on more than 2,000 precepting encounters between a faculty pharmacist and family practice residents, most encounters represented requests by residents for information on general drug management of diseases. The pharmacist answered most questions based on clinical knowledge and experience. Evaluations of the pharmacist by the residents indicated that she is an effective teacher and useful in helping take care of patients.