Day 1:

Advanced CBRN Pharmacy Course: Introduction and Toxicological Thinking

1. Describe the context and need for advanced training in medical management of CBRN casualties
2. Apply the CRESS algorithm to identify toxidromes (consciousness, respirations, eyes, secretions, skin)
3. Identify opportunities to treat chemical, biological, radiological, and nuclear (CBRN) casualties through the LADMER (liberation, absorption, distribution, metabolism, elimination, response) approach
4. Recognize useful reference materials for management of CBRN casualties

Advanced Pharmacological Management of Nerve Agent Casualties

1. Describe nerve agent pathophysiology from molecular to patient level
2. Manage nerve agent casualties at the Role 3/4, and intensive care setting
3. Recognize novel and contingency treatments for cholinergic crisis
4. Integrate NATO-Ally formularies to manage nerve agent casualties
5. Prepare for management of multiple simultaneous severe nerve agent casualties

Metabolic Intoxication

1. Describe fundamental principles for identifying and treating a casualty with a metabolic agent intoxication.

Management of Opioids, Anticholenergics, and Miscellaneous Agents

1. Describe the pharmacokinetic properties of naloxone, including its absorption, distribution, metabolism, and elimination.
2. Identify an appropriate antidote for a person poisoned with thallium or arsenic describing its mechanism of action and administration protocol.
3. Select the appropriate pharmacological agent to manage agitation, autonomic activity, and prevent or treat seizures, given a case involving a patient exposed to anticholinergic agents.

Day 2

Shelf-Life Extension Program (SLEP): Ensuring DoD Preparedness for CBRN Response

1. Describe the importance of and initial formation of the Department of Defense (DoD) and Food and Drug Administration’s (FDA’s) Shelf-Life Extension Program (SLEP)
2. Summarize eligibility requirements for enrolling medications into SLEP
3. Outline chemical treatment considerations for chemical and nerve agent exposures
4. Identify inventory considerations and potential use rates when responding to a chemical attack
5. Compare USCENTCOM’s informal

SLEP program to the DoD’s SLEP program Pulmonary Agents and Vesicants

1. Identify the clinical effects and rates of recovery of pulmonary agents and vesicants.
2. Summarize the pharmacological therapies used to manage patients exposed to pulmonary agents and vesicants.
3. Given a patient case, select the agent used and appropriate treatment based on exposure history and symptoms.

Day 3 (No CEUs)