Pharmacotherapy Specialty Recertification Literature Study: Module 1A-D (Cert #L249132)

Module 1A: Cardiovascular Diseases
ACPE #: 0204-9999-24-940-H01-P

This module focuses on current issues in the management of cardiovascular diseases. Topics include heart failure with preserved ejection fraction, chronic coronary disease, acute ischemic stroke, and cardiovascular effects of testosterone-replacement therapy. 

Kittleson M, Panjrath G, Amancherla K, et al. 2023 ACC Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction. J Am Coll Cardiol. 2023 May, 81 (18) 1835–1878.

• Describe the 2023 American College of Cardiology Expert Consensus Decision Pathway on Management of Heart Failure With Preserved Ejection Fraction
• Develop recommendations for diagnosing and treating patients with heart failure with preserved ejection fraction (HFpEF) 

Kosiborod MN, Abildstrom SZ, Borlaug BA, et al. Semaglutide in patients with heart failure with preserved ejection fraction and obesity. N Engl J Med. 2023;389:1069-1084.

• Describe the Effect of Semaglutide 2.4 mg Once Weekly on Function and Symptoms in Subjects with Obesity-related Heart Failure with Preserved Ejection Fraction (STEP-HFpEF) trial by Kosiborod and colleagues
• Develop recommendations for the use of semaglutide in adults with heart failure with preserved ejection fraction (HFpEF) and obesity 

Virani SS, Newby LK, Arnold SV, et al. 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association/American College of Cardiology Joint Committee on Clinical Practice Guidelines. Circulation. 2023;148(9):e9-e119.* 

*Focus on: 4.2 (Guideline-directed management and therapy), 4.3 (Medical therapy to Prevent CV events and manage symptoms) [e29-e60]

• Describe the multiorganizational guideline for the management of patients with chronic coronary disease (CCD) from the American Heart Association (AHA)/American College of Cardiology (ACC) Joint Committee on Clinical Practice Guidelines
• Develop recommendations for the management of patients with chronic coronary disease (CCD) 

Nissen SE, Lincoff AM, Brennan D, et al. Bempedoic acid and cardiovascular outcomes in statin-intolerant patients. N Engl J Med 2023; 388: 1353-1364.

• Describe the CLEAR study by Nissen and colleagues of bempedoic acid in statin-intolerant patients with or at high risk for cardiovascular disease
• Develop recommendations for the use of bempedoic acid in statin-intolerant patients with or at high risk for cardiovascular disease 

Chen H, Cui Y, Zhou Z, et al. Dual antiplatelet therapy vs alteplase for patients with minor nondisabling acute ischemic stroke: The ARAMIS randomized clinical trial. JAMA 2023; 329: 2135-2144.

• Describe the Antiplatelet vs R-tPA for Acute Mild Ischemic Stroke (ARAMIS) study by Chen and colleagues
• Develop recommendations for the treatment of patients with minor nondisabling acute ischemic stroke 

Lincoff AM, Bhasin S, Flevaris P, et al; TRAVERSE Study Investigators. Cardiovascular Safety of Testosterone-Replacement Therapy. N Engl J Med. 2023 Jul 13;389(2):107-117.

• Describe the Testosterone Replacement Therapy for Assessment of Long-term Vascular Events and Efficacy Response in Hypogonadal Men (TRAVERSE) study
• Develop recommendations for the use of testosterone-replacement therapy in middle-aged and older men with hypogonadism who have or are at high risk for cardiovascular (CV) disease

Module 1B: Gastrointestinal Diseases and Geriatrics
ACPE #: 0204-9999-24-941-H01-P

This module focuses on current issues in the management of gastrointestinal diseases and older adult patients. Topics include lower gastrointestinal bleeding and hepatitis C guidelines, updated Beers criteria®, and respiratory syncytial virus vaccines. 

Sengupta N, Feuerstein JD, Jairath V, et al. Management of patients with acute lower gastrointestinal bleeding: an updated ACG guideline. Am J Gastroenterol 2023; 118: 208-231. Focus on: pgs 209-216, 220, 223.

• Describe the updated American College of Gastroenterology (ACG) guideline on the management of patients with acute lower gastrointestinal bleeding (LGIB)
• Develop recommendations for the management of patients with acute lower gastrointestinal bleeding (LGIB) 

Bhattacharya D, Aronson A, Price J, Lo Re V III; the American Association for the Study of Liver Diseases–Infectious Diseases Society of America HCV Guidance Panel. Hepatitis C guidance 2023 update: American Association for the Study of Liver Diseases–Infectious Diseases Society of America recommendations for testing, managing, and treating hepatitis C virus infection. Clin Infect Dis. 2023; ciad319. https://doi.org/10.1093/cid/ciad319.

• Describe the 2023 update from the American Association for the Study of Liver Diseases and Infectious Diseases Society of America with recommendations for testing, managing, and treating hepatitis C virus (HCV) infection
• Develop recommendations for the testing, management, and treatment of patients with hepatitis C virus (HCV) infection 

American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71:2052-2081.

• Describe the American Geriatrics Society (AGS) 2023 updated Beers Criteria® for potentially inappropriate medication use in older adults
• Develop recommendations for pharmacotherapy in older adults, taking into consideration the American Geriatrics Society (AGS) 2023 updated Beers Criteria® for potentially inappropriate medication use in this patient population 

Melgar M, Britton A, Roper LE, et al. Use of respiratory syncytial virus vaccines in older adults: recommendations of the Advisory Committee on Immunization Practices - United States, 2023. MMWR 2023; 72: 793-801

• Describe the 2023 Advisory Committee on Immunization Practices recommendations for the use of respiratory syncytial virus (RSV) vaccines in older adults
• Develop recommendations for the administration of respiratory syncytial virus (RSV) vaccines to older adults

Module 1C: Pulmonary Diseases and Critical Care
ACPE #: 0204-9999-24-942-H01-P

This module focuses on current issues in pulmonary diseases and critical care. Topics include chronic obstructive lung disease, pulmonary arterial hypertension, therapeutic use of tranexamic acid and hypertonic saline, and management of life-threatening toxicity due to poisoning. 

Agusti A, Celli BR, Criner GJ, et al. Global initiative for chronic obstructive lung disease 2023 report: GOLD executive summary. Am J Respir Crit Care Med 2023; 207: 819-837.

• Describe the executive summary of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2023 report
• Develop recommendations for the diagnosis and treatment of chronic obstructive pulmonary disease (COPD) 

Hoeper MM, Badesch DB, Ghofrani HA, et al; STELLAR Trial Investigators. Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension. N Engl J Med. 2023 Apr 20;388(16):1478-1490.

• Describe the STELLAR study of sotatercept for the treatment of pulmonary arterial hypertension
• Develop recommendations for the use of sotatercept for the treatment of symptomatic patients with pulmonary arterial hypertension 

The PATCH-Trauma Investigators and the ANZICS Clinical Trials Group. Prehospital tranexamic acid for severe trauma. N Engl J Med 2023.

• Describe the Pre-hospital Antifibrinolytics for Traumatic Coagulopathy and Hemorrhage (PATCH-Trauma) trial of tranexamic acid in adults with major trauma and suspected trauma-induced coagulopathy
• Develop recommendations for the prehospital administration of tranexamic acid to adults with major trauma and suspected trauma-induced coagulopathy who are being treated in advanced trauma systems 

Sigmon J, Crowley KL, Groth CM. Therapeutic review: The role of tranexamic acid in management of traumatic brain injury, nontraumatic intracranial hemorrhage, and aneurysmal subarachnoid hemorrhage. Am J Health Syst Pharm. 2023; 18: 1213-1222.

• Describe the use of tranexamic acid in patients with intracranial hemorrhage (ICH) associated with traumatic brain injury (TBI), nontraumatic (i.e., spontaneous) ICH, and aneurysmal subarachnoid hemorrhage (aSAH)
• Develop recommendations for the use of tranexamic acid in patients with intracranial hemorrhage (ICH) associated with traumatic brain injury (TBI), nontraumatic (i.e., spontaneous) ICH, and aneurysmal subarachnoid hemorrhage (aSAH) 

Holden DN, Mucksavage JJ, Cokley JA. Hypertonic saline use in neurocritical care for treatment cerebral edema: a review of optimal formulation, dosing, safety, administration and storage. Am J Health-Syst Pharm 2023; 80: 331-342.

• Describe the optimal formulation, dosing, administration (method, rate, and route), monitoring, and storage of hypertonic saline (HTS) solutions used to treat neurocritical care patients with cerebral edema to ensure safety
• Develop recommendations for the optimal formulation, dosing, administration (method, rate, and route), monitoring, and storage of hypertonic saline (HTS) solutions used to treat neurocritical care patients with cerebral edema to ensure safety 

Lavonas EJ, Akpunonu PD, Arens AM, et al. 2023 American Heart Association focused update on the management of patients with cardiac arrest or life-threatening toxicity due to poisoning: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2023;148:e149-e184.

• Describe the 2023 American Heart Association (AHA) focused update on the management of patients with cardiac arrest or life-threatening toxicity due to poisoning
• Develop recommendations for the management of patients with cardiac arrest or life-threatening toxicity due to poisoning

Module 1D: Endocrine, Infectious Diseases and Immunology
ACPE #: 0204-9999-24-944-H01-P

This module focuses on various contemporary issues in pharmacotherapy. Topics include diabetes management in chronic kidney disease, management of myasthenia gravis, guidelines for the use of prolonged-infusion beta-lactam antibiotics, and the use of hydrocortisone in pneumonia. 

De Boer IH, Khunti K, Sadusky T, et al. Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Kidney International 2022; 102: 974-989.

• Describe the consensus report from the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO) about the management of diabetes mellitus in chronic kidney disease
• Develop recommendations for treatment of screening, diagnosing, and treating patients with diabetes mellitus and chronic kidney disease (CKD) 

Marriott M, Schwery A, VandenBerg A. Myasthenia gravis: what does a pharmacist need to know? Am J Health-Syst Pharm 2023; 80: 249-257.

• Describe the pathophysiology and treatment of myasthenia gravis (MG) and commonly used medications that can cause new onset or acute worsening of the disease
• Develop recommendations for the treatment of patients with myasthenia gravis (MG) 

Hong LT, Downes KJ, FakhriRavari A, et al. International consensus recommendations for the use of prolonged-infusion beta-lactam antibiotics: endorsed by the American College of Clinical Pharmacy, British Society for Antimicrobial Chemotherapy, Cystic Fibrosis Foundation, European Society of Clinical Microbiology and Infectious Diseases, Infectious Diseases Society of American, Society of Critical Care Medicine, and Society of Infectious Diseases Pharmacists. Pharmacotherapy 2023; 43: 740-777

• Describe the multiorganizational international consensus recommendations for the use of prolonged-infusion beta-lactam antibiotics
• Develop recommendations for the use of prolonged-infusion beta-lactam antibiotics for the treatment of patients with bacterial infections 

Dequin PF, Meziani F, Quenot JP, et al. Hydrocortisone in severe community-acquired pneumonia. N Engl J Med 2023; 388: 1931-1941

• Describe the Community-Acquired Pneumonia: Evaluation of Corticosteroids (CAPE COD) study of intravenous hydrocortisone in patients with severe community-acquired pneumonia (CAP) admitted to the intensive care unit
• Develop recommendations for the use of intravenous hydrocortisone in patients with severe community-acquired pneumonia (CAP) admitted to the intensive care unit