Cardiology Pharmacy Specialty Review Course for Recertification + RECERT EXAM Package (Cert # L239244)

These recertification activities are intended for board certified pharmacists seeking to update their knowledge and skills in cardiology pharmacy.

Board certified pharmacists are eligible to receive up to 23.75 contact hours of recertification credit for completing this course. To earn recertification credit, learners must review the course content and successfully complete the online assessments by the deadline. Only completed assessments will be eligible for credit; no partial or incomplete assessments will be processed.  You are allowed only one attempt to successfully complete this assessment. 

This course is not intended for those preparing to take the BPS Cardiology Pharmacy Specialty Examination for Certification. To prepare for the examination, please see courses here: http://elearning.ashp.org/catalog/cards-review. 

These activities are part of the ACCP and ASHP professional development program for BCCP recertification approved by the BPS. 

At the end of this activity, you will be able to:

Primary Prevention of Cardiovascular Disease and Public Health
ACPE #: 0217-9999-23-080-H01-P
• Identify pharmacotherapeutic agents that reduce the risk of developing cardiovascular disease (CVD).
• Develop a treatment plan that incorporates lifestyle modifications and evidence-based pharmacotherapy to reduce the risk of an index cardiovascular event for a given patient scenario.
• Develop a tobacco cessation treatment plan for a patient who requests assistance for a quit attempt.
• Evaluate a given patient scenario to determine CVD risk and recommend appropriate lipid therapy.
• Determine appropriate patients to recommend initiation of aspirin therapy for the primary prevention of CVD.
• Counsel a patient on appropriate complementary and alternative pharmacotherapeutic agents to optimize CVD risk reduction, including vitamin D and omega-3 fatty acids.

Dyslipidemia
ACPE #: 0217-9999-23-081-H01-P
• Describe the role of cholesterol and lipoproteins in the development of atherosclerotic cardiovascular disease (ASCVD).
• Evaluate a patient’s ASCVD risk by appropriately using the 10-year ASCVD Risk Pooled Cohort Equations and optional risk enhancers.
• Establish goals of therapy for the management of blood cholesterol, including statin intensity, and create a monitoring plan for patients receiving lipid-lowering therapies.
• Develop an appropriate treatment regimen for patients who are statin intolerant or unable to achieve goals of therapy on maximally tolerated statin therapy according to the 2018 Guideline on the Management of Blood Cholesterol and the 2022 Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk.
• Identify appropriate indications for the use of triglyceride-lowering therapies to manage hypertriglyceridemia.
• Evaluate the needs of special populations (e.g., those with diabetes, older adults, those with kidney disease), and adapt treatment strategies to optimize outcomes.

Blood Pressure Management in Adult Patients
ACPE #: 0217-9999-23-082-H01-P
• Develop an optimal pharmacologic treatment plan for a patient with hypertension (HTN) according to practice guidelines and clinical trial evidence.
• Demonstrate appropriate drug selection and blood pressure goals for the treatment of HTN according to concomitant conditions and compelling indications.
• Devise an evidence-based treatment strategy for resistant HTN to achieve blood pressure goals.
• Construct appropriate drug therapy plans for the treatment of hypotension and/or antihypertensive drug related adverse events.

Stable Atherosclerotic Disease
ACPE #: 0217-9999-23-083-H01-P
• Recommend patient-specific pharmacologic therapy for the management of stable ischemic heart disease (SIHD).
• Differentiate between the antianginal options for a patient with refractory angina.
• Develop an optimal pharmacologic regimen and monitoring plan for patients with peripheral arterial disease (PAD) considering individual patient symptomatology and characteristics.
• Develop an evidence-based pharmacologic regimen for secondary prevention of ischemic stroke and transient ischemic attack (TIA).
• Recommend risk factor modification strategies to prevent a recurrent event for patients with SIHD, PAD, and ischemic stroke/TIA.

Anticoagulation
ACPE #: 0217-9999-23-084-H01-P
• Recommend a patient-specific pharmacotherapy plan to reduce the risk of stroke in patients with atrial fibrillation (AF).
• Devise an evidence-based pharmacotherapy plan for preventing and treating venous thromboembolism (VTE).
• Analyze the need for anticoagulation in patients with AF or VTE.
• Determine appropriate reversal strategies for patients at risk of bleeding, or actively bleeding while receiving anticoagulation therapy.
• Determine appropriate selection and dosing of anticoagulant therapy on the basis of patient-specific factors and drug interactions.
• Evaluate literature and clinical implications of data for patients receiving anticoagulant agents.

Arrhythmias
ACPE #: 0217-9999-23-085-H01-P
• Describe the principles of basic electrocardiogram (ECG) interpretation.
• Distinguish risk factors and etiologies, clinical features, signs and symptoms, and goals of therapy of sinus bradycardia, atrial fibrillation (AF), supraventricular tachycardia (SVT) (including Wolff-Parkinson-White syndrome [WPW]), premature ventricular complexes (PVCs), and ventricular tachycardia (VT).
• Compare and contrast appropriate pharmacologic and nonpharmacologic treatment options for the management of sinus bradycardia, AF, SVT, PVCs, and VT.
• Compare and contrast the mechanisms of action of drugs used for ventricular rate control and conversion to and maintenance of sinus rhythm in patients with AF.
• Recommend strategies to improve transitions of care between inpatient and outpatient settings for patients on antiarrhythmic drugs.
• Develop evidence-based patient-specific pharmacotherapy plans for patients with symptomatic sinus bradycardia, AF, SVT (including WPW), PVCs, and VT.
• Assess common and important drug-drug interactions and adverse effects associated with drugs used for the management of arrhythmias and their complications.

Drug-Induced Cardiovascular Disease and Drugs to Avoid in Cardiovascular Disease
ACPE #: 0217-9999-23-086-H01-P
• Identify potential drug-induced cardiovascular diseases.
• Analyze a medication list to determine causative agents for common drug-induced cardiovascular diseases.
• Evaluate potential medications that can contribute to the development of torsades de pointes.
• Review anticancer therapies that cause cardiovascular toxicities.
• Evaluate patient characteristics and laboratory values to assess the risk of heparin-induced thrombocytopenia and develop an appropriate treatment plan.

Chronic Heart Failure
ACPE #: 0217-9999-23-087-H01-P
• Given a patient with heart failure (HF), describe the classifications, staging, clinical presentation, etiologies, and diagnostic considerations.
• Describe the pathophysiology of HF, focusing on the role that neurohormonal and other vasoactive agents play in HF progression.
• Given a patient with chronic HF, devise an appropriate pharmacologic and nonpharmacologic therapeutic plan, with an emphasis on guideline-directed therapy and management.
• Given a patient with chronic HF and several comorbidities, devise an appropriate evidence-based pharmacotherapy plan addressing specific comorbidities related to HF.

Decompensated Heart Failure
ACPE #: 0217-9999-23-088-H01-P
• Classify a patient with decompensated heart failure (HF) into a hemodynamic subset based on signs/ symptoms, laboratory values, and hemodynamic measures obtained via pulmonary artery catheter (PAC) monitoring.
• Design an initial pharmacotherapeutic treatment and monitoring plan for a patient with decompensated HF based on hemodynamic subset.
• Devise a modified treatment and monitoring plan in a patient with decompensated HF and diuretic resistance.
• Compare and contrast the use of intravenous (IV) vasodilators and positive inotropes in the treatment of decompensated HF, and among the agents within each drug class.
• List strategies for reducing the risk of HF readmission among patients recovering from decompensated HF.

Heart Transplant and Mechanical Circulatory Support
ACPE #: 0217-9999-23-089-H01-P
• Evaluate levels of risk in the heart transplant candidate.
• Derive rational peri- and postoperative rejection mitigation strategies in heart transplant recipients.
• Devise effective thromboprophylactic strategies for patients receiving percutaneous ventricular assist device support.
• Construct safe and effective drug therapy regimens for patients receiving extracorporeal membrane oxygenation support.
• Design effective treatment plans for patients with complications of durable left ventricular assist device therapy.

Acute Coronary Syndrome
ACPE #: 0217-9999-23-090-H01-P
• Distinguish between reperfusion strategies for acute coronary syndrome (ACS): ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation (NSTE) ACS.
• Devise a pharmacotherapeutic treatment plan for a patient with STEMI undergoing primary percutaneous coronary intervention (PCI) and for a patient with NSTE-ACS undergoing an early invasive or ischemia-guided approach.
• Differentiate between the best possible pharmacologic options for preventing thrombotic events in the acute management of ACS.
• Analyze differences in evidence, pharmacology, pharmacokinetics, drug-drug interactions, monitoring, and adverse events between the P2Y12 inhibitors and anticoagulants used in ACS management.
• Devise an individualized evidence-based treatment plan for patients in need of secondary prevention post-ACS, including mortality-reducing therapies.

Cardiovascular Emergencies
ACPE #: 0217-9999-23-091-H01-P
• Choose appropriate management pathways/treatment for a patient with cardiac arrest according to patient presentation.
• Differentiate between the various categories of shock.
• Select the optimal management strategies for the various types of shock.
• Construct a pharmacotherapy regimen for the various hypertensive crises.
• Select an appropriate management plan for a patient presenting with acute aortic syndrome.
• Design a pharmacotherapy plan for the management of acute ischemic stroke.

Pulmonary Arterial Hypertension
ACPE #: 0217-9999-23-092-H01-P
• Describe the classification of pulmonary hypertension and implications for treatment.
• Discuss the importance of pulmonary arterial hypertension (PAH) pathobiology and the role of various pathways as treatment targets in the development of PAH-specific treatment.
• Define treatment goals for the management of PAH.
• Outline targeted medications for PAH, including indications, dosing, monitoring, and their place within current treatment algorithms.
• Identify common adverse effects and drug interactions associated with PAH medications.
• Highlight appropriate treatment approaches for the management of decompensated PAH.
• Design a treatment plan for a patient with PAH.

Specialized Topics in Cardiovascular Disease
ACPE #: 0217-9999-23-093-H01-P
• Recommend empiric antibiotic therapy for patients with suspected infective endocarditis (IE).
• Develop a therapeutic plan regarding medication therapy for patients with IE or patients requiring prophylactic therapy for IE prevention.
• Identify patients who require IE prophylactic therapy.
• Develop a treatment plan for patients with pericarditis.
• Recommend appropriate therapy for patients with myocarditis.
• Plan a medication therapy regimen for patients with valvular heart disease.

Translation of Evidence into Practice
ACPE #: 0217-9999-23-094-H01-P
• Identify different types of data (nominal, ordinal, continuous) to determine the appropriate type of statistical test (parametric vs. nonparametric).
• Select appropriate statistical tests based on the anticipated sample distribution, data type, and study design.
• Identify the most appropriate study design to answer a given research question.
• Describe the key tenets of internal and external validity of cardiovascular-related trials.
• Describe the advantages and disadvantages of surrogate and composite outcomes in cardiovascular studies.

Principles of Cardiology Pharmacy Practice Administration
ACPE #: 0217-9999-23-095-H01-P
• Distinguish between policies, procedures, and clinical protocols related to the medication use process.
• Identify formulary management activities to improve the prescribing of safe, effective, and affordable treatments in an organization.
• Describe strategies to plan for and respond safely and efficiently to drug product shortages.
• List high-risk medications and medication-related processes that are suited for a medication use evaluation (MUE) and recognize the steps in the MUE process.
• Describe national quality initiatives and regulatory requirements aimed at improving health care delivery and patient health outcomes.
• Define pharmacoeconomic principles and be able to apply them to patient care.
• Compare a medication error, adverse drug event (ADE), adverse drug reaction (ADR), and preventable ADE.
• Analyze an ADE reporting program, including committee structure, committee reporting mechanisms, and methods of detecting, reporting, and managing ADEs.

Full faculty bios

William L. Baker, Pharm.D., FCCP, FACC, FAHA, FHFSA*
Associate Professor of Pharmacy Practice
University of Connecticut School of Pharmacy
Storrs, Connecticut

Theodore Berei, Pharm.D., MBA, BCPS, BCCP
Clinical Pharmacist, Advanced Heart Failure and Transplant Cardiology
University of Wisconsin Hospitals and Clinics
Madison, Wisconsin

Scott Bolesta, Pharm.D., FCCP, FCCM, BCCCP
Associate Professor of Pharmacy Practice
Wilkes University
Wilkes-Barre, Pennsylvania

Brandon E. Cave, Pharm.D., AACC, AHSCP-CHC
Clinical Pharmacist Practitioner – Cardiology
West Palm Beach VA Healthcare System
West Palm Beach, Florida

James C. Coons, Pharm.D., FCCP, FACC, BCCP*
Professor University of Pittsburgh School of Pharmacy
Clinical Pharmacist, Cardiology UPMC
Pittsburgh, Pennsylvania

Paul P. Dobesh, Pharm.D., FCCP, FACC, FAHA, BCPS, BCCP*
Professor of Pharmacy Practice and Science
University of Nebraska Medical Center
College of Pharmacy
Omaha, Nebraska

Steven P. Dunn, Pharm.D., FCCP, FAHA, BCCP
Lead Pharmacist, Heart & Vascular
University of Virginia Health System
Charlottesville, Virginia

Stormi E. Gale, Pharm.D., BCCP, BCPS
Clinical Pharmacist, Cardiology Subject Matter Expert
Novant Health Matthews Medical Center
Matthews, North Carolina

Genevieve M. Hale, Pharm.D., BCPS, BCCP, CPh
Associate Professor
Nova Southeastern University College of Pharmacy
Palm Beach Gardens, Florida

Carol Heunisch, Pharm.D., BCPS, BCCP
Director, Drug Policy and Education
NorthShore – Edward-Elmhurst Health
Evanston, Illinois

Douglas L. Jennings, Pharm.D., FCCP, FACC, FAHA, FHFSA
Associate Professor of Pharmacy Practice, Long Island University
Clinical Pharmacist, Heart Transplant and LVAD Team
New York Presbyterian Hospital Columbia University Irving Medical Center
New York, New York

Kelly C. Rogers, Pharm.D., FCCP, FACC, BCCP*
Professor of Clinical Pharmacy and Translational Science
University of Tennessee College of Pharmacy
Cardiology Clinical Specialist, VAMC
Memphis, Tennessee

Dustin D. Spencer, Pharm.D., MBA, FCCP, BCPS, BCCP
Clinical Director, Cardiopulmonary Diseases
Cardinal Health
Martinsville, Indiana

Nathan J. Verlinden, Pharm.D., BCPS, BCCP
Cardiology Clinical Pharmacy Specialist
Allegheny General Hospital
Pittsburgh, Pennsylvania

Elisabeth M. Wang, Pharm.D., BCCP
Clinical Assistant Professor
University of Houston College of Pharmacy
Houston, Texas

Zachary R. Noel, Pharm.D., BCCP, BCPS
Assistant Professor
University of Maryland School of Pharmacy
Baltimore, Maryland

*Content matter experts

Cassandra Benge, PharmD, BCCP, AACC
Mary Blanton Covell, PharmD, MPH, BCPS, BCCP
Jessica M. Casey, PharmD, BCPS, BCCP
Maya R. Chilbert, PharmD, BCCP
James C. Coons, PharmD, FCCP, FACC, BCCP
Sandeep Devabhakthuni, PharmD, BCPS, BCPP
Julianne Fallon, PharmD, BCCP
Sydney Graboyes, PharmD, MBA, BCCP
Edward T. Horn, PharmD, BCCCP
Cynthia A. Jackevicius, BScPHm, PharmD, MSc, BCPS, BCCP
Kazuhiko Kido, PharmD, BCPS, BCCP
Tamara Malm, PharmD, MPH, BCPS
Kristin E. Montarella, PharmD, BCPS, BCPP
Barbara S. Wiggins, PharmD, BCPS, BCCP, BCCCP
Kathleen Willenbourg, PharmD, BCPS, BCCP
Kevin M. Wohlfarth, PharmD, BCPS, BCCCP, BCCP

Aaron Adkisson, PharmD
Nicholas Barker, PharmD, BCCP, BCCCP
Daniel Blee, PharmD, BCCP
Heidi Brink, PharmD, BCPS, BCCP
Amy Lynne Brokenshire, PharmD, BCPS, BCCP, BCCCP, CACP
Sara Brouse, PharmD, FCCP, BCPS, BCCP
Franco Wing Tak Cheng, MClinPharm, BCPS, BCCP
Allison Chidester, PharmD, BCCP
Albert Czachor, PharmD, BCCP
Audrey Dettwiller, PharmD, BCCP
Paul Dobesh, PharmD, BCCP, BCPS
Rachel Eaton, PharmD, BCCP, MBA
Noha Mahmood Morsi Eldesoki, BCCP
Emad Elkholy, PharmD, BCCCP, BCCP
Amr Fahmi, MSc, BCCP
Lindsey Federle, PharmD, BCCP, BCPS
Sydney Graboyes, PharmD, MBA, BCCP
Lindsey Griner, PharmD, BCPS, BCCP
Genevieve Hale, PharmD, BCPS, BCCP, CPh
Carol Heunisch, PharmD, BCPS, BCCP
Christine Ji, PharmD, BCPS, BCCP
Erin Kohler, PharmD, BCCP, BCCCP
Brian Lindvahl, PharmD, BCPS, BCCP
Melanie Madorsky, PharmD, BCPS, BCCP, BCCCP
Emily McElhaney, PharmD, BCCP
Nicole Mehl, PharmD, BCCP
Richard Mullvain, RPh, BCCP, BCPS
Helen Ngo, BCPS, BCCP
Zachary Noel, PharmD, BCCP
Cassidy Oliver, PharmD, BCPS, BCCP
Ami Patel, PharmD
Christina Ruggia-Check, PharmD, BCTXP, BCCP,BCPS
David Silva, PharmD, BCPS, BCCP
Andrew Smith, PharmD, FCCP, BCCP, BCPS
Dustin Spencer, PharmD, MBA, FCCP, BCPS, BCCP
Elisabeth Sulaica, PharmD, BCCP
Alicia Surber, PharmD, BCPS, BCCCP, BCCP
Elizabeth Tesch, PharmD, BCCP, BCPS
Brandi Thoma, PharmD, BCPS, BCCP
Liz Wang, PharmD, BCCP
Kristin Watson, PharmD, BCCP
Kathryn Weber, PharmD, BCPS, BCCP
Barbara S. Wiggins, PharmD, BCPS, BCCP, BCCCP
Kate Willenborg, PharmD, BCPS, BCCP
Seeba Zachariah, MPharm, PhD, BCPS, BCCP

In accordance with our accreditor’s Standards of Integrity and Independence in Accredited Continuing Education, ASHP requires that all individuals in control of content disclose all financial relationships with ineligible companies. An individual has a relevant financial relationship if they have had a financial relationship with an ineligible company in any dollar amount in the past 24 months and the educational content that the individual controls is related to the business lines or products of the ineligible company.

An ineligible company is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The presence or absence of relevant financial relationships will be disclosed to the activity audience.

• Clinical Education and Research Liaison: Barbara S. Wiggins (scPharmaceuticals)
• Consultant: Theodore Berei (Cytogenetics); Brandon E. Cave (Novartis); James C. Coons (Pfizer–Bristol Myers Squibb Alliance); Paul P. Dobesh (Pfizer–Bristol Myers Squibb Alliance, Janssen Pharmaceuticals); Steven P. Dunn (Abiomed); Stormi E. Gale (Pharmacosmos); Douglas L. Jennings (Abiomed, La Jolla Pharmaceuticals); Paul P. Dobesh (Pfizer–Bristol Myers Squibb Alliance, Janssen)
• Employee: Dustin D. Spencer (Cardinal Health); Rachel Eaton (Janssen)
• Grant Funding/Research Support: James C. Coons (Heart Rhythm Society, Pfizer–Bristol Myers Squibb Alliance); Stormi E. Gale (United Therapeutics)
• Reviewer: Stormi E. Gale (Actelion)
• Speaker’s Bureau: Brandon E. Cave (AstraZeneca Pharmaceuticals); Stormi E. Gale (Kiniksa); Douglas L. Jennings (Abiomed, AstraZeneca Pharmaceuticals, La Jolla Pharmaceuticals, Merck Pharmaceuticals)

All other persons in control of content do not have any relevant financial relationships with an ineligible company.

As required by the Standards of Integrity and Independence in Accredited Continuing Education, all relevant financial relationships have been mitigated prior to the CPE activity.

Activities can be completed in any order. Each activity consists of audio, video, and/or PDFs and evaluations. Learners must review all content and complete the evaluations to receive continuing pharmacy education credit for each activity. 

Follow the prompts to claim, view, or print the statement of credit within 60 days after completing the activity. 

ACCP and ASHP collaborate on cardiology pharmacy activities.