Pharmaceuticals | ACMT Total Tox Course
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Register
- Non-member - Tier I - $225
- Non-member - Tier II - $225
- Non-member - Tier III - $150
- Non-member - Tier IV - $100
- Member - Tier I - $200
- Member - Tier II - $200
- Member - Tier III - $125
- Member - Tier IV - $75
ACMT presents the ACMT Total Tox Course activity on Pharmaceuticals! In this self-paced activity, expert speakers delve into systematic approaches for managing poisoned patients. It will cover the mechanisms of toxicity and treatment guidelines for substances like acetaminophen, NSAIDs, and SSRIs. Interactive case studies allow you to apply theoretical knowledge to real-world scenarios, strengthening your clinical decision-making skills.
The content of this course consists of recordings from the live, virtual Pharmaceuticals activity of the 2024 ACMT Total Tox Course. The content has been edited and packaged into this on-demand version featuring 14 asynchronous lectures from experts in the field of medical toxicology.
Registration for this activity includes 90 day access to the on-demand material and up to 8.00 Continuing Education credits.
Target Audience
This activity is designed for a diverse audience including physicians, pharmacists, advanced practice nurses, nurses, physician assistants, medics, EMTs, SPIs, laboratorians, poison center educators, first responders, and residents and students eager to expand their expertise.
Continuing Education
Enduring continuing education credits for Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners is provided by AKH Inc., Advancing Knowledge in Healthcare. Learners will receive up to 8.0 credits for learning and change.
For more information, click here.
Learning Objectives
After Completing This Program You Should Be Able To:
- Discuss general care of poisoned patients including clinical toxidromes, common diagnostic tests, antidotes and other treatment options.
- Recognize, and understand treatment of, specific over-the-counter agent poisonings such as acetaminophen, NSAIDs, and antihistamines.
- Evaluate the toxicity of psychiatric, cardiovascular, anticonvulsant and other prescription medication classes including therapeutic management advances.
Questions?
Please write to ACMT at events@acmt.net
If you are interested in the other activities in this course, check out the links below!
Syllabus
Total Activity Length: approximately 8 hours (481 minutes)
PRE-TEST | 15 min
12 multiple-choice questions to ascertain your baseline knowledge on the topic.
From Toxidromes to Activated Charcoal: A Rational Approach For Managing the Poisoned Patient | 45 min
Ann Arens, MD Associate Professor of Emergency Medicine, University of Minnesota, Minneapolis, MN
Dr. Arens will identify the most common interventions performed in acute poisoning, and will examine a poisoned patient to identify what to look for in common poisonings. She will also discuss different treatment options for common toxidromes.
Over-the-Counter Poisons #1: Acetaminophen | 28 min
Neeraj Chhabra, MD, MSCR Medical Toxicologist & Emergency Medicine Physician, University of Illinois Chicago, Chicago, IL
Dr. Chhabra will discuss acetaminophen ingestions. He will explain how to recognize which patients require treatment and identify novel treatments for acetaminophen-related poisoning.
Over-the-Counter Poisons #2: NSAIDS and ASA | 46 min
Renee Petzel Gimbar, PharmD Clinical Associate Professor, University of Illinois Chicago College of Pharmacy, Chicago, IL
Dr. Petzel Gimbar will describe the treatment of NSAID poisoning, discuss the pathophysiology of salicylate poisoning, and examine the difference between treatment for NSAID and salicylate poisoning.
Over-the-Counter Poisons #3: Antihistamines & Antitussives | 30 min
Michelle Hieger, DO Emergency Physician and Medical Toxicologist, WellSpan Health & VCU Health System, York, PA
Dr. Hieger will describe the action of antitussive medications and the pharmacology of antihistaminics with emphasis on clinical uses, adverse drug reactions and interactions. She will also identify major antihistamines used to treat breathing problems.
The Ins and Outs of Ups and Downs #1: Tricyclic Antidepressants & Antipsychotics | 48 min
J.J. Rasimas, MD, PhD, FAACT, FACLP, FACMT, FACPsych Professor of Psychiatry & Emergency Medicine, University of Minnesota & Penn State College of Medicine, Minneapolis, MN
Dr. Rasimas will explain the pharmacologic, toxicity, and treatment differences between Tricyclic Antidepressants and Antipsychotics. He will discuss "typical" vs. "atypical" antipsychotics and describe the overlapping features of Serotonin Syndrome, Anticholinergic Syndrome, and NMS produced by TCAs and Antipsychotics.
The Ins and Outs of Ups and Downs #2: SSRIs and Lithium | 32 min
Katherine Katzung, MD, FACEP, FASAM Director of Addiction & Toxicology Program & Emergency Care Physician, Abbott Northwestern Hospital & Emergency Care Consultants, Minneapolis, MN
Dr. Katzung will identify unique concerns of specific antidepressants in overdose and compare differences in acute vs. chronic lithium toxicity. She will also discuss drug discontinuation syndrome as it applies to SSRIs & atypical antidepressants.
Beta Blockers and Calcium Channel Blockers: When the Antagonists Become Antagonistic | 29 min
William "Russ" Kerns, II, MD, FACMT, FACEP Emeritus Professor of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
Dr. Kerns will examine treatment options focusing on high-dose insulin vs vasopressor controversy and discuss mechanisms of toxicity, clinical manifestations, and updates on optimal therapy for beta-adrenergic blocking drugs and calcium channel antagonists drugs.
Drug-Induced Dysrhythmias: When You Can't Control the Rhythm | 25 min
William "Russ" Kerns, II, MD, FACMT, FACEP Emeritus Professor of Emergency Medicine, Carolinas Medical Center, Charlotte, NC
Dr. Kerns will return after the case conference to examine optimal treatment of drug-induced dysrhythmias and discuss how the optimal management of drug-induced dysrhythmias differs from AHA ACLS algorithms.
Anticoagulants and Antithrombotics: When You Can't Control the Bleeding | 46 min
Nena Bowman, PharmD, DABAT Director of Vaccine Operations, Vaccine Preventable Diseases and Immunization Program, Tennessee Department of Health, Nashville, TN
Dr. Bowman will identify appropriate uses of reversal agents for common anticoagulants and summarize the latest data in NOAC trials. She also will review the mechanism of action, indications, contraindications, adverse reactions, and common drug interactions of warfarin.
Out of Balance: Toxicity of Endocrine Agents | 34 min
Charles McKay, MD, FACMT Associate Medical Director, CT Poison Control Center, University of Connecticut School of Medicine, Farmington, CT
Dr. McKay will examine management issues with overdose of endocrine drugs, and discuss endocrine clues and mimics and endocrine function impact of ‘non-endocrine’ medications.
Anticonvulsants: When the Level Makes You Unsteady | 28 min
Daniel J. Sessions, MD Medical Toxicologist, Ochsner Medical Center, New Orleans, LA
Dr. Sessions will identify treatment options for anticonvulsant toxicity, examine laboratory testing is required for toxicity from anticonvulsant agents, and discuss the toxicity of common anticonvulsants.
Antimicrobials & Antivirals: When the Cure Becomes Toxic | 32 min
Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT Emergency Medicine Attending Physician and Associate Professor Of Emergency Medicine, MedStar Washington Hospital Center & Georgetown University Hospital, Washington, D.C.
Dr. Amirshahi will discuss the mechanism of action of the five major classes of antimicrobials. She will describe the potential toxicities of commonly prescribed antimicrobial treatments and assess the likelihood of a cross-reaction between penicillin and cephalosporin.
Case Panel - Advanced Acetaminophen | 14 min
Several speakers from previous lectures return to review and discuss clinical cases on acetaminophen toxicity.
Case Panel - Beta Blockers and Calcium Channel Blockers | 14 min
Several speakers from previous lectures return to review clinical cases on beta blockers and calcium channel blockers.
POST-TEST | 15 min
Retake the same 12 multiple-choice questions asked during the pre-test and compare your scores to assess your learning.
Maryann Amirshahi, PharmD, MD, MPH, PhD, FACMT
Emergency Medicine Attending Physician, Professor Of Emergency Medicine, Co-Medical Director
MedStar Washington Hospital Center, Georgetown University Hospital, National Capital Poison Center
Dr. Maryann Amirshahi is a Professor of Emergency Medicine at Georgetown University School of Medicine and practices clinically at MedStar Washington Hospital Center, where she specializes in toxicology, addiction care, and emergency medicine. She holds a PharmD and medical degree, alongside an MPH focusing on environmental and occupational health, and a PhD in pharmacology and public health. Dr. Amirshahi is board-certified in emergency medicine, medical toxicology, addiction medicine, and clinical pharmacology, and is a registered pharmacist with over a decade of practice. Nationally recognized, she serves on the Board of Directors for the American College of Medical Toxicology and as co-medical director of the National Capital Poison Center. With nearly 200 peer-reviewed publications, her research spans medication safety, drug shortages, addiction treatment, and prescription drug misuse.
Ann Arens, MD
Emergency Medicine Physician
Ochsner Medical Center
Dr. Arens is an Emergency Medicine physician who practices at Ochsner Medical Center in New Orleans, LA. Dr. Arens completed her Emergency Medicine training at the Denver Health Residency in Emergency Medicine, and her medical toxicology training at the University of California – San Francisco. She was amongst the first toxicologists to identify and describe counterfeit fentanyl products, and has continued to identify outbreaks of new drugs of abuse. She has a broad range of research interests including: the identification of new drugs of abuse including novel opioids contributing to the current opioid epidemic, the use of antidotes, and advanced supportive care of the poisoned patient.
Nena Bowman, PharmD, DABAT
Director of Vaccine Operations
Vaccine Preventable Diseases and Immunization Program, Tennessee Department of Health
Nena Bowman received her Bachelor of Science in Biochemistry at Middle Tennessee State University in 2010 and her Doctorate of Pharmacy at Lipscomb University College of Pharmacy in 2014. Bowman completed a specialty fellowship in Toxicology with the Utah Poison Control Center at the University of Utah in Salt Lake City, Utah in 2016. She is board certified as a clinical toxicologist, Diplomate of the American Board of Applied Toxicology (DABAT). Dr. Bowman currently practices at the Tennessee Department of Health as the Director of Vaccine Operations and a Toxicologist Consult for the Emergency Preparedness Program. Bowman works closely with providers across the state to ensure proper utilization of federal vaccine program funds, and equal access to all ACIP recommended vaccines for underserved children and adults. She also teaches at Lipscomb University College of Pharmacy as an adjunct professor in toxicology and emergency preparedness curriculum. She is an Advanced Hazmat Life Support (AHLS) Provider and Instructor, and she is the immediate past president of the Nashville Area Pharmacists Association. She enjoys working in public health to educate providers, consulting on difficult toxicology situations, and problem solving to navigate unprecedented events and challenges.
Neeraj Chhabra, MD, MSCR
Medical Toxicologist & Emergency Medicine Physician
University of Illinois Chicago
Neeraj Chhabra, MD, MSCR is an Emergency Physician and Medical Toxicologist based in Chicago, Illinois. He provides medical toxicology consulting services for the Illinois Poison Center and Cook County Health. Dr. Chhabra completed his fellowship in medical toxicology with the Toxikon Consortium in 2017 and his master’s degree in clinical research at Rush University Graduate College in 2020. His clinical focus is on the acute management of poisonings and overdose.
Michelle Hieger, DO
Emergency Physician, Medical Toxicologist, and Addiction Medicine Physician
Wellspan Health, York, PA
I am a board-certified Medical Toxicologist, Addictionologist, and Emergency Medicine physician. I completed my residency at Memorial Hospital in York, PA. My fellowship was completed at Virginia Commonwealth University in Richmond, VA. I currently work at WellSpan York Hospital in York, PA, as an Emergency Physician, Medical Toxicologist, and working with in-patients starting treatment for addiction. I initiated the toxicology service at York Hospital and now I am the Medical Director for Medical Toxicology. I am interested in treating the poisoned patients at bedside, and especially interested in the antidotal therapy with physostigmine (if it returns) and flumazenil. I enjoy professional engagement with ACMT.
Katherine Katzung, MD, FACEP, FASAM
Director of Addiction & Toxicology Program & Emergency Care Physician
Abbott Northwestern Hospital & Emergency Care Consultants
Katherine Katzung, MD is an attending physician in the emergency department at Abbott Northwestern, where she serves as chair of the department. Additionally, she is the medical director of the hospital’s addiction medicine and toxicology program, which began in 2020 after she received grant funding to initiate a hospital-based toxicology/addiction medicine consult service as well as an emergency department-based addiction medicine "bridge" clinic to provide continuity of care for patients initiated on Suboxone. This innovative program allows patients evaluated at Abbott Northwestern in the emergency department or inpatient units continuity of care, while focusing on harm-reduction strategies, until they can be given a warm hand-off to community providers.
A graduate of the University of Minnesota School of Medicine, she completed emergency medicine training at Regions Hospital in St. Paul and additional fellowship training in medical toxicology. She is board certified in emergency medicine, medical toxicology, and addiction medicine. Her clinical interests surround the intersection of these 3 specialties, with special focus on early ED & hospital-based interventions to evaluate and treat substance use disorder, including initiation of medication assisted therapies.
She volunteers as a consultant for the Minnesota Poison Control System in addition to serving on the board of the Steve Rummler HOPE Network and acts as medical director of its overdose prevention program.
William "Russ" Kerns, II, MD, FACMT, FACEP
Emeritus Professor of Emergency Medicine
Carolinas Medical Center
Dr. Kerns trained in Emergency Medicine and Medical Toxicology and served as Professor in both disciplines at Carolinas Medical Center for 33 years. Faculty roles included leadership of the Medical Toxicology Fellowship and clinical division, consultation for the Carolinas Poison Center, and research. Research interests included antidotes, envenomation, and resuscitation of cardiotoxic drugs. He also served the ACMT focusing on advancing research and education.
Charles McKay, MD, FACMT
Associate Medical Director
CT Poison Control Center, University of Connecticut School of Medicine
Dr. McKay was trained in Anatomic and Surgical Pathology, Internal Medicine, Emergency Medicine, Medical Toxicology and was a Medical Director of Occupational Health and Medical Review Officer for a hospital system during more than 30 years of clinical practice, during which he provided toxicology consultation at 3 hospitals, directed a medical toxicology fellowship training program, and provided medical oversight of a regional poison control center. He provides medical legal consultation across the country on toxicology-related issues, and has testified in nearly 100 cases, many related to questions of alcohol- and -drug-induced impairment.
Renee Petzel Gimbar, PharmD
Clinical Associate Professor
University of Illinois Chicago College of Pharmacy
Renee Petzel Gimbar received her PharmD from the University of Illinois at Chicago College of Pharmacy and completed PGY-1 training at UIC and PGY-2 training at Rutgers University. She started emergency medicine pharmacy services at the University of Tennessee Medical Center Knoxville and Loyola University Medical Center. She was inducted as a fellow of the American Academy of Clinical Toxicology in 2019. She currently is a clinical associate professor in the department of pharmacy practice at UIC College of Pharmacy, an Emergency Medicine and Medical Toxicology Clinical Pharmacist at UI Health, and the Residency Program Director for the PGY-2 Emergency Medicine Pharmacy Residency. She has integrated herself in the emergency medicine and medical toxicology services at both Loyola and UIC, active in the acute care of patients, didactic and beside education of healthcare trainees. Dr. Petzel Gimbar has been involved in multiple research studies and publications related to emergency medicine and toxicology practice, including a current multi-year NIH study addressing emergency department hypertension in underserved patients. She has given invited lectures internationally and nationally on both emergency medicine and medical toxicology topics. At home, she attempts to manage her nine, seven, and five year olds without a toxic ingestion.
J.J. Rasimas, PhD, MD, FAACT, FACLP, FACMT, FACPsych
Professor of Psychiatry & Emergency Medicine
Dalhousie University, University of Minnesota, & Penn State College of Medicine
Dr. Rasimas has a Jesuit university background in biochemistry, mathematics, and philosophy. He completed the Medical Scientist Training Program, earning a PhD in chemical biology (2002) and MD (2003) from Penn State University. After Psychiatry residency at the Mayo Clinic, he was a clinical fellow at the National Institutes of Health in Washington, DC where he did translational research and trained in medical ethics. He also undertook formal education in psychoanalytic psychotherapy, completed the critical care based medical toxicology fellowship at Penn State, and became certified in Psychosomatic Medicine, Addiction Medicine, and Medical Toxicology. Further work at NIH has included the Undiagnosed Diseases Program and roles in research ethics and oversight. Dr. Rasimas was the Director of Consultation-Liaison Psychiatry and Co-Chair of the Biomedical Ethics Committee at Hennepin County Medical Center in Minneapolis, Minnesota before moving to Prince Edward Island, Canada in 2022. Based at Queen Elizabeth Hospital in Charlottetown, he served as the lead Psychiatrist for C-L and Addictions for the province. He has recently transitioned to Nova Scotia Health in an effort to build treatment programs for patients with complex psychosomatic illnesses and substance use. For PEI, Dr. Rasimas remains the Medical Director of the Atlantic Mentorship Network for Chronic Pain, Addictions, and Mental Illness. Dr. Rasimas is a university professor with continued involvement in medical education in both the US and Canada pursuing an academic medical career at the interface of psychosomatic medicine, medical toxicology, and psychodynamic psychotherapy with a primary clinical interest in the phenomenology of suicide.
Daniel J. Sessions, MD, FACMT, FASAM, FAAEM
Chief, Division of Medical Toxicology
Ochsner Medical Center
Dr. Sessions practices medical toxicology, emergency medicine and addiction medicine at Ochsner Health in the New Orleans area. Dr. Sessions has expertise in poisoning and drug overdose, envenomation, toxic occupational exposure, medication assisted therapy for opioid and alcohol use disorder and forensic toxicology. Dr. Sessions earned his degree in medicine from Louisiana State University School of Medicine in New Orleans in 2008. He is board-certified in emergency medicine and medical toxicology by the American Board of Emergency Medicine in 2012 and 2014. He completed a medical toxicology fellowship at the Rocky Mountain Poison & Drug Center at Denver health in Denver in 2013. He is board-certified in addiction medicine by the American Board of Preventative Medicine in 2022. Dr. Sessions actively participates in the American Academy of Emergency Medicine, the American College of Medical Toxicology, the American Academy of Clinical Toxicology and the American Society of Addiction Medicine.
Registration Rates
Registration includes:
- 90-day access to all course content
- Access to the Speaker slides
- 8.0 Continuing Education Certificate. Available credits: Pharmacists, Physicians, Physician Associates, Nurses, and Nurse Practitioners.
Member Rates
Member Tier I: Full, Affiliate, International, Emeritus |
$200 |
Member Tier II: Fellows |
$200 |
Member Tier III: Residents, International - Developing Country |
$125 |
Member IV: Medical Students |
$75 |
Non-Member Rates
Non-member Tier I: Physicians, Pharmacists, Lawyers, "Other" |
$225 |
Non-member Tier II: Fellows, SPIs, Nurses, etc. |
$225 |
Non-member Tier III: Educators & Emergency Responders |
$150 |
Non-member IV: Residents & Students |
$100 |
ACMT Membership
ACMT Members receive a discounted rate. Interested in becoming an ACMT Member? Contact our Membership Team at membership@acmt.net. Learn more at: www.acmt.net/membership
Package Rates
Sign up for the full ACMT Total Tox Course and save $100!
Refunds and Cancellations
For information on ACMT's Cancellation and refund policy, click here.
Questions?
For any questions, please email us at events@acmt.net.
Instructions
Once you have completed your registration:
- Click on the Contents tab. This is where you will be able to see all lectures and required content for this course.
- Complete the Pre-Test. You are not required to pass the Pre-Test, this is to test your skills before you begin the on-demand course.
- Watch all lectures and case panels. Learners will be required to watch at least 3/4 of the video before it will be marked as complete.
- Complete the Post-Test. These questions are based on content from the lectures to gauge your comprehension of the lectures. It requires a 80% to pass.
- Complete the CE Survey. These questions are required to claim your CE certificate.
- Claim your CE certificate. Once you have claimed your CE credit, you will not be able to change your CE certificate.
Full credit can only be claimed after completion of all required components.
Hardware/Software Requirements
Computer or Other Internet-Enabled Device; Internet Connection; Browser.
Materials
None.
Prerequisites
None.
Format
This is a self-guided course with CME, CNE, CPE, AAPA CME, and AANP CE.
Need Assistance or Have Questions?
For assistance logging in, accessing content, purchasing or completing Continuing Education credits, or for other questions, please contact us at events@acmt.net or visit our FAQ page.
If you are in need of accessible learning accommodations, please contact events@acmt.net for additional assistance.
Continuing Education
ACMT Total Tox Course – Pharmaceuticals
On-Demand Course
Release Date: December 6, 2024
Expiration Date: December 6, 2025
CE credit provided by AKH Inc., Advancing Knowledge in Healthcare.
Criteria for Success
To obtain a certificate of completion, a score of 70% or better on the post-test is required. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your certificate. You must participate in the entire activity to receive credit. There is no fee to participate in this activity. If you have questions about this activity, please contact AKH Inc. at events@acmt.net.
Please claim your credit by December 6, 2025
If you have questions about this CE activity, please contact AKH Inc at bethany@akhcme.com
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
In support of improving patient care, this activity has been planned and implemented by AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This activity was planned by and for the healthcare team, and learners will receive 8.0 Interprofessional Continuing Education (IPCE) credit for learning and change.
Physicians
AKH Inc., Advancing Knowledge in Healthcare designates this live activity for a maximum of 8.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
Credit being awarded: 8.0 ANCC contact hours.
Nurse Practitioners
This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of AKH Inc., Advancing Knowledge in Healthcare and American College of Medical Toxicology (ACMT). AKH Inc., Advancing Knowledge in Healthcare is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 030803. This activity is approved for 8.0 contact hour(s) (which includes 8.0 hour(s) of pharmacology).
Physician Associate
AKH Inc., Advancing Knowledge in Healthcare has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 8.0 AAPA Category 1 CME credits. Approval is valid until 12/6/2025.
PAs should only claim credit commensurate with the extent of their participation.
Pharmacists
AKH Inc., Advancing Knowledge in Healthcare designates this continuing education activity for 8.0 contact hours.
Commercial Support
This activity is supported from an independent medical education grant from BTG international lnc.,
Disclosures
It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of its continuing education activities. The author must disclose to the participants any significant relationships with ineligible companies whose products or devices may be mentioned in the activity or with the commercial supporter of this continuing education activity. Identified conflicts of interest are mitigated by AKH prior to accreditation of the activity. AKH planners and reviewers have no relevant financial relationships to disclose.
Disclosure of Unlabeled Use and Investigational Product
This educational activity may include discussion of uses of agents that are investigational and/or unapproved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Disclaimer
This course is designed solely to provide the healthcare professional with information to assist in his/her practice and professional development and is not to be considered a diagnostic tool to replace professional advice or treatment. The course serves as a general guide to the healthcare professional, and therefore, cannot be considered as giving legal, nursing, medical, or other professional advice in specific cases. AKH Inc. specifically disclaim responsibility for any adverse consequences resulting directly or indirectly from information in the course, for undetected error, or through participants misunderstanding of the content. If you would like to opt out from future communications from AKH please send an email to optout@akhcme.com with your information with "Opt Out" in the subject line.