Cardiology Pharmacy Specialty Review Course, Workbook Chapters, and Practice Exam (No Recert Credit) (Cert # L249167)

The Cardiology Pharmacy Preparatory Review and Recertification Course is designed to help pharmacists who are preparing for the Board of Pharmacy Specialties certification examination in Cardiology Pharmacy as well as those seeking a general review and refresher on disease states and therapeutics. The program goals are as follows:

• To present a high-quality, up-to-date overview of cardiovascular disease states and therapeutics; review cardiology pharmacy practice management techniques; and review biostatistical principles and literature evaluation methods relevant to cardiology pharmacy practice;
• To provide a framework to help attendees prepare for the specialty certification examination in cardiology phar-macy practice; and
• To offer participants an effective learning experience using a case-based approach with a strong focus on the thought processes needed to solve patient care problems in each therapeutic area.

This course consists of 16 activities (see table below) and provides up to 23.75 contact hours of continuing pharmacy education credit. The Review Course includes case-based presentations for application to real-life scenarios, a practice exam along with correct answers, and links to the reference sources, and domains, tasks, and knowledge statements. To help you further prepare, this package includes a compilation of practice questions in the same format and rigor to help you prepare for the BPS Specialty Examination.       

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

Primary Prevention of Cardiovascular Disease and Public Health
ACPE #: 0217-9999-24-139-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 ofCVD.
• 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 #: 0217-9999-24-140-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.E
• 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 #: 0217-9999-24-141-H01-P

• Develop an optimal pharmacologic treatment plan for a patient with hypertension (HTN) according to practice guidelines and clinical trialevidence.
• Demonstrate appropriate drug selection and blood pressure goals for the treatment of HTN according to concomitant conditions and compellingindications.
• Devise an evidence-based treatment strategy for resistant HTN to achieve blood pressuregoals.
• Construct appropriate drug therapy plans for the treatment ofhypotension and/or antihypertensive drug related adverse events.

Stable Atherosclerotic Disease
ACPE #:0217-9999-24-142-H01-P

• Recommend patient-specific pharmacologic therapy for the management of chronic coronary disease (CCD).
• Differentiate between the antianginal options for a patient with refractoryangina.
• 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 CCD, PAD, and ischemicstroke/TIA.

Anticoagulation
ACPE #: 0217-9999-24-143-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 #: 0217-9999-24-144-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 #: 0217-9999-24-145-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 #: 0217-9999-24-146-H01-P

• Given a patient with heart failure (HF), describe the classifications, staging,clinical presentation, etiologies, and diagnosticconsiderations.
• Describe the pathophysiology of HF,focusing on the rolet hat neurohormonal and other vasoactive agents play in HFprogression.
• 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 toF.

Decompensated Heart Failure
ACPE #: 0217-9999-24-147-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 #: 0217-9999-24-148-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 #: 0217-9999-24-149-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 conservative 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 #: 0217-9999-24-150-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 #: 0217-9999-24-151-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 #: 0217-9999-24-152-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 #: 0217-9999-24-153-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 #: 0217-9999-24-154-H01-P

• Distinguish 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.

Supplemental material

Pharmacogenomics of Cardiovascular Disease

Full faculty bios

William L. Baker, PharmD, FCCP, FACC, FAHA, FHFSA
Associate Professor, Department of Pharmacy Practice
University of Connecticut School of Pharmacy
Storrs, Connecticut 

Theodore Berei, PharmD, MBA, BCCP, FHFSA
Clinical Specialist, Advanced Heart Failure and Transplant Cardiology
University of Wisconsin Health
Madison, Wisconsin 

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

Brandon E. Cave, PharmD, BCCP, AACC, AHSCP-CHC
Clinical Pharmacist Practitioner - Cardiology
Tomah VA Medical Center
Tomah, Wisconsin 

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

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

Steven P. Dunn, PharmD, FCCP, FAHA, BCCP
Lead Pharmacist, Heart and Vascular
University of Virginia Health System
Charlottesville, Virginia 

Stormi E. Gale, PharmD, BCCP, BCPS
Clinical Pharmacist Practitioner
Novant Health Heart and Vascular Institute
Charlotte, North Carolina 

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

Carol Heunisch, PharmD, BCPS, BCCP
Director, Drug Policy and Education, North Region
Endeavor Health
Highland Park, Illinois 

Xena (Xinyi) Huang, PharmD, BCPS
Advanced Heart Failure/Transplant Pharmacy Fellow
Arnold & Marie Schwartz College of Pharmacy
Long Island University
NewYork-Presbyterian Hospital
New York, New York 

Douglas L. Jennings, PharmD, 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 

Zachary R. Noel, PharmD, BCCP, BCPS
Assistant Professor
University of North Carolina at Chapel Hill
Eshelman School of Pharmacy
Chapel Hill, North Carolina 

Kelly C. Rogers, PharmD, FCCP, FACC, BCCP
Professor of Clinical Pharmacy and Translational Science
University of Tennessee College of Pharmacy
Memphis, Tennessee 

Adam J. Smith, PharmD, BCPS, BCCCP, BCCP
Specialty Practice Pharmacist - Acute Care Surgery & Trauma, Operating Room
The Ohio State University Wexner Medical Center
Columbus, Ohio 

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

Marissa N. Uricchio, PharmD, BCCP
Clinical Pharmacy Specialist – Cardiology
Cooperman Barnabas Medical Center
Livingston, New Jersey

*Content matter experts

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. 

The following persons in control of this activity’s content have relevant financial relationships:

• Consultant: James C. Coons (Pfizer–Bristol Myers Squibb Alliance, Merck); Paul P. Dobesh (Pfizer–Bristol Myers Squibb Alliance, Janssen Pharmaceuticals, Astra Zeneca Pharmaceuticals); Stormi E. Gale (Wolters Kluwer); Douglas L. Jennings (La Jolla Pharmaceuticals)
• Employee: Dustin D. Spencer (Cardinal Health)
• Grant Funding/Research Support: James C. Coons (Heart Rhythm Society, Pfizer–Bristol Myers Squibb Alliance);
• Speaker’s Bureau: Brandon E. Cave (AstraZeneca Pharmaceuticals)
• Clinical Education and Research Liaison: Barbara S. Wiggins (scPharmaceuticals)
• Employee: Megan M. Clark (Syneos)
• Advisory Board: Megan Clarke (Jannssen Pharmaceuticals)
• Stock:  Sydney Grayboyes (Innovia Medical – sold 12/2022) 

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.

To maintain its strict, independent standards for certification, BPS does NOT endorse or provide review information, preparatory courses, or study guides for Board Certification Examinations.