Pinterest is a free social media pinboard photo sharing website that allows users to create and manage image collections. Users can categorize images on different boards and follow other users’ boards if they have similar interest. Pinterest users can upload, save, sort, and manage images know as pins and other media content. Some people use Pinterest to collect images, photos, or organize resources such as the tools we are learning in this course.

I personally think this is a fun tool for those who like to collect images for their own personal interest and to share with others. You can pin your favorite images and also find out what others are interested in. This tool allows you to organize your images, but you can also do that on your computer hard-drive or Googledrive. I think the difference is because with Pinterest you can obtain comments and “likes” from others on your images and you can also provide comments on other people’s images. I really like the fact that you can research through a great variety of images. However, being an instructor, I would NOT use any images from Pinterest due to copyright violations (users beware!!!),  since it would likely require checking each individual site where the images come from to see if they are authorized for use. I frequently look for images in the internet for educational purposes for my presentations, but sometimes end up buying images to include on my presentations due to copyrights violations.

Here is an article about this topic: Is Pinterest a Haven for Copyright Violations?

For professional use I think this tool can be used to show students a visual of required books, educational tools or resources directly from your Pinterest account.

I do have a Pinterest account for over a year now and have rarely used it. I may consider using it to keep track of the social tools we are learning in this course. I recently discovered their section on education and found nice images and resources in this category. I think navigating through this section may be good to obtain ideas, however unfortunately like I mentioned before, I would not use these images for professional use due to copyrights violations.

Check out my Pinterest account:

If you are interested on this tool  you can create a free account at


Fellowship Year 1 Celebration

Category: Life in Academia as a Fellow

1 year down and 1 more to go…

I am very grateful and thankful to God for being surrounded by amazing people, being in a wonderful learning environment, and having the best mentors one could ask for…I could not be happier!

“Choose a job you love, and you will never have to work a day in your life.” Confucius

My Wonderful Fellowship Director Dr. Sturpe

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Thank you Drs. Deborah Sturpe, Stuart Haines, and Katie Kiser for working so closely with me this past year and being such wonderful mentors to me! I am very grateful for all you taught me and continue to teach me! Thank you for your patience, your guidance and for sharing your knowledge…thank you for molding me into a better person! I can not thank you enough!

Thank you both Drs. Magaly Rodriguez de Bittner and Lauren Hynicka for providing opportunities and being such wonderful role models to me! I look forward for helping out again with the Medical Spanish Terminology course this coming Fall!

Thank you Ms. Barbara Hunter, Yolanda Johnson, Lisa Calvert Chalk and Laura Seipp for always being there and willing to help!

Drs. Charmaine Rochester, Chanel Agness, and Ivy Muteithia

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Thank you Drs. Charmaine Rochester, Chanel Agness, and Kristin Watson for all your support and for sharing your life path in academia with the residents and I! We learned a lot from you!

Thank you Dr. Lynn Mcpherson for sharing your experiences and resources. I am enjoying very much to take a course with you this Summer (2013)!

Drs. Roshni Patel, Charmaine Rochester, Deborah Sturpe

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Residents and Fellows, Class of 2013

Residents and Fellows Year 1

I also learned a lot from my co-residents and fellows! Thank you all and congratulations on being done with residency!


Organization-Centric or Network-Centric?

I am current a Fellow at University of Maryland College of Pharmacy. From the short period of time I have been at the University, I have noticed that the Institution supports creativity, implementation of innovative ideas, and encourages employees to be in the “cutting edge” of pharmacy education, research and patient care.

I believe the Institution is in the process of transition from “organization-centric” to “network-centric”, as the concept of “interprofessional education” is being promoted by our new president and supported by various departments. I envision the Institution creating an interprofessional education center to facilitate sharing and connection among different professions.

I really like the idea of having an interprofessional portal for the institution, where employees from various professions (pharmacy, medicine, nursing, social work, law, dentistry, graduate school) can share resources, best practices, post questions/answers, and learn with, from and about each other.

Β-Blockers And Hypertension: Where Are The Data?

Citation: Parker ED, Margolis KL, Trower NK, et al. Comparative Effectiveness of 2 β-Blockers in Hypertensive Patients. Arch Intern Med 2012: 172: 1406-12.
Category: Hypertension
Original commentary found in, written by: Jenna M. Siskey, PharmD, Adraine L. Lyles, PharmD, BCPS, and Dave L. Dixon, PharmD, BCPS

Commentary Written By: Livia Macedo, PharmD

This study compares both B-blockers atenolol and metoprolol tartrate in patients without compelling indications. Compelling indications in which B-blocker therapy is recommended includes heart failure with reduce ejection fraction, acute myocardial infarction, high coronary disease risk, and diabetes. Currently, in JNC 7, B-blockers are recommended as second line in these patients, after a thiazide diuretic, and equally recommended as ACEI, angiotensin II receptor blockers, and calcium channel blockers. However, the 2007 American Heart Association recommends B-blockers as 3rd or 4th line for the treatment of hypertension in these patients. The results of the study by Parker, et al. showed there was no difference between atenolol and metoprolol tartrate in reducing MI, HF, stroke, or cardiovascular event in patients with hypertension without compelling indications. I personally would recommend B-blockers as a 3rd or 4th line in patients with hypertension without compelling indications. I would first recommend thiazide diuretic, ACEI or ARB, and CCB. Then, if needed would recommend a B-blocker such as atenolol rather than metoprolol tartrate because of its once daily dosing; and would recommend metoprolol tartrate as an alternative option if atenolol is not appropriate for the patient. What would you do?

Check out iForumRx for the more details on this article at

Dosing Blood Pressure Medications At Bedtime: Improve Outcomes?

Citation: Hermida RC, Ayala DE, Mojon A, and Fernandez JR. Influence of Time of Day of Blood Pressure- Lowering Treatment on Cardiovascular Risk in Hypertensive Patients with Type 2 Diabetes. Diabetes Care. 2011; 34: 1270-76.
Category: Diabetes, Hypertension
Original commentary found in, written by: Joshua W. Fleming, Pharm.D. and Patricia A. Ross, Pharm.D., BCPS

Commentary Written By: Livia Macedo, PharmD

This study commented how dosing blood pressure medications at bedtime might reduce risk of cardiovascular events, specifically in patients who are “non-dippers”. I learned that the term non-dippers is used when referred to patients who don’t normally have a 10% drop in blood pressure overnight. This non-dipping blood pressure pattern has been associated with a higher risk of cardiovascular events. The authors from the original study claim that by moving 1 or more blood pressure medication to bedtime will not only decrease nocturnal blood pressure, but will also decrease cardiovascular events and increase event free survival. However, Fleming, et al. points out several limitations associated with this study. The study is not specific with regards to what classes of blood pressure medications should be moved to bedtime. Dose adjustments and baseline blood pressure medication are not reported. In addition, this study was conducted only in one center in Spain, and may not be generalizable in locations with a more diverse population. These factors make it challenging to replicate this study in other settings. Although, this study has limitations, I think it can still be applicable in practice as an alternative option for patients who are non-dippers with uncontrolled nocturnal and awakening blood pressure, and are consistently adherent to their medications. In this situations, I think it would be okay to recommend to take one of their blood pressure medications at bedtime (definitely not a diuretic though, due to inconvenience for the patient), and monitor for improvement in their nocturnal and morning blood pressure. Definitely encourage adherence as most important. I don’t think it would be a good idea to ask patients who are currently non-adherent to their medication to take one blood pressure medication at bedtime, because that would make their medication regimen more complex, and increase likelihood of them missing doses, which could potentially worsen their clinical outcome. What are your thoughts? Would you consider recommending  a blood pressure medications at bedtime? If so, which class of blood pressure medications?

Check out iForumRx for the more details on this article at

Is Tiotropium Appropriate For Uncontrolled Asthma?

Citation:  Kerstjens HAM, Engel M, Dahl R et. al. Tiotropium in Asthma Poorly Controlled with Standard Combination Therapy.  N Engl J Med 2012; 367:1198-1207.

Moderator: Roshni Patel, Pharm.D., PGY2 Ambulatory Care Pharmacy Resident

Panelists:  Mona Tsoukleris, Pharm.D. and Dennis Williams, Pharm.D.

Category: Ambulatory Care

Commentary Written By: Livia Macedo, PharmD

I read about the study discussion posted on Feb 18 by Dr. Patel “Tiotropium in asthma poorly controlled with standard combination therapy”.  This study was a two replicate randomized, double-blind, placebo-controlled trial which included patients (N=912) of age 18-75 years with asthma for >5 years diagnosed before age 40, lifelong nonsmokers or people who had a smoking history of fewer than 10 pack years with no smoking in the year before enrollment.  They excluded patients with COPD, serious coexisting illness, and concurrent use of anticholinergic bronchodilators. The study compared the effect on lung function and exacerbations of adding tiotropium 5 mcg or placebo, both delivered by a soft-mist inhaler once daily for 48 weeks. The results of this study showed that the addition of tiotropium to ICS and LABA therapy reduced the risk for exacerbations and improved lung function.  However the study presented with some limitations. Patients included in this study could have mixed asthma and COPD. To ensure these patients had solely asthma, they should have included patients from a different age group of 18-35 instead. In addition, this study was sponsored by the product’s manufacturer, which could have led to study bias. This agent may be a therapeutic option for patients with mixed asthma and COPD.  I think more research is needed at this time to determine whether this agent is a treatment option for patients solely with asthma. What are your thoughts? When would you consider the use of tiotropium?

Check out iForumRx for the more details on this article at

Screen Recording Tools: Jing and Screenr


JIng (Photo credit: blogpocket)

This week I learned about two new tools Jing and Screenr. Jing is great for free screen recordings and capture! Download here  I also learned about Screenr, this tool is similar to Jing.

Both tools have a limit of 5 min for recordings, which is great for short videos. If you use Jing and desire to record a video longer than 5 min, you can upgrade to a tool called “Snagit 11”, which is also very simple to use and there is no time limit for your video. Although, there is a cost associated with it. You may get the free 30-day trial. Here you go:

Image representing Screenr as depicted in Crun...

Image via CrunchBase

My blog image capture with Jing 

Working Smart and Learn How to Use Twitter

Working Smart Through Workscaping by Jay Cross, 2010

“If you set high expectations of people, they usually live up to them. If you have low expectations of people, they live down to them.” It is important to nurture your network within and outside your workspace. I like the tips to workscaping provided by Jay Cross such as apply the 80/20 rule to critical functions and avoiding duplication of effort in keeping up with news.

How to Use Twitter for Social Learning by Jane Hart, 2010

I learned how to create a background for my twitter account by using Free Twitter Designer found on: Very cool tool! Check out at @lmacedopharmd

How Networks Are Changing Social Change

Citation: Kasper G, Scearce D. Working Wikily: How Networks Are Changing Social Change.

Category: Social Media, Education, #EDUC689

Commentary Written By: Livia Macedo

I thought it was interesting the comment about “blur the line between amateurs and experts”. Amateurs are now able to publish their opinions on the internet alongside those of experts via various social media tools (e.g. YouTube, Blog).

I also agree with regards to privacy and security, users must be careful with what they share publicly online as it may come back to haunt them. The concept of “privacy” and “security” will need to be redefined in the world of social media.

One thing I learned this past week is that this new generation of students are losing or not learning the ability to read non-verbal expressions and participating in face-to-face interactions, because they are so used to using technology!

English: Blended learning methodology graphic

English: Blended learning methodology graphic (Photo credit: Wikipedia)

I think there should be a balance between face-to-face interactions and social media networking interactions in education, and that can be achieved via a blended learning environment.