advanced pharmacy practice experience (APPE) availability and needs for 4 colleges and schools of pharmacy in Georgia and Alabama and to examine barriers and offer potential solutions to increase APPE site and preceptor availability. Methods. Data on APPE needs and availability were gathered prospectively and evaluated relative to current and projected enrollment and planned programmatic changes. Results. Combined 2006-2007 non-community APPE needs and availabilities were 3,590 and 4,427, respectively, with a surplus availability of 837. Combined projected 2010-2011 non-community APPEs were estimated at 4,309. Assuming 2006-2007 non-community availability remained unchanged, the surplus availability declined to 118. Conclusions. The need for quality experiential education represents a significant barrier and rate-limiting step to the matriculation of the increased numbers of pharmacists. Barriers to expanding APPE availability include: introductory pharmacy practice experience (IPPE) and APPE expansion, growth of new and existing pharmacy programs, financial instability of acute care facilities, and lack of preceptor development resources. Regional experiential education consortiums can provide a constructive approach to improve access to quality sites and preceptors through standardizing processes and leveraging resources.

We report the first published case of severe, symptomatic hyponatremia resulting from syndrome of inappropriate antidiuretic hormone (SIADH) incurred as the result of a blow to the head inducing a concussion without any additional signs of head injury. A 38-year-old male in excellent health suffered a fall from a tree causing a right leg fracture and blunt trauma to the head with concussion but no other signs of head injury. The patient was discharged several days after surgery for repair of his leg fracture and subsequently became severely ill with nausea, vomiting, headache, and seizures. He was readmitted with a serum sodium of 114 mEq/L (mmol/L) with a presumed diagnosis of dehydration. After several days of saline administration he was discharged, but within 24 hours he again experienced severe, symptomatic hyponatremia and was admitted for the third time with a serum sodium of 110 mEq/L (mmol/L). A diagnosis of SIADH was made, and the patient was successfully treated with fluid restriction, intravenous saline, and demeclocycline resulting in a full recovery without further incident. This case emphasizes the need to consider SIADH as a possible cause of severe hyponatremia in patients sustaining relatively minor closed head trauma.