Cardiology Pharmacy Specialty Review Course, Workbook Chapters (No Recert Credit) (L269090)

These activities are intended for pharmacists who are seeking to update their knowledge and skills commensurate with a board certification examination in the areas listed below.

This course consists of 16 activities (see table below) and provides up to 24.50 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.       

After participating in this CPE activity, learners should be able to: 

ACPE Number: 0217-9999-26-096-H01-P

Primary Prevention of Cardiovascular Disease and Public Health

• Identify pharmacotherapeutic agents that reduce the risk of developing cardiovascular disease (CVD).
• Design 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.
• Use recent guidelines to recommend initiation of aspirin for the primary prevention of CVD in appropriate patients.
• Recommend complementary and alternative pharmacotherapeutic agents to optimize CVD risk reduction, including vitamin D and omega-3 fatty acids.

Dyslipidemia

• 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

• Design 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.
• Create 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.

ACPE Number: 0217-9999-26-097-H01-P

Stable Atherosclerotic Disease

• Recommend patient-specific pharmacologic therapy for the management of chronic coronary disease (CCD).
• 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 non-cardioembolic ischemic stroke and transient ischemic attack (TIA).
• Recommend risk factor modification strategies to prevent a recurrent event for patients with CCD, PAD, and non-cardioembolic ischemic stroke/TIA.

Anticoagulation

• 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.

ACPE Number: 0217-9999-26-098-H01-P

Arrhythmias

• 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

• Identify potential drug-induced cardiovascular diseases (CVDs).
• Analyze a medication list to determine causative agents for common drug-induced CVDs.
• Assess medications that can contribute to the development of torsades de pointes.
• Review anticancer therapies that cause CV toxicities.
• Evaluate patient characteristics and laboratory values to assess the risk of heparin-induced thrombocytopenia and develop an appropriate treatment plan.

ACPE Number: 0217-9999-26-099-H01-P

Chronic Heart Failure

• 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

• 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

• Evaluate levels of risk in the heart transplant recipient.
• Design rational peri- and post-operative rejection mitigation strategies in heart transplant recipients.
• Apply effective thromboprophylactic strategies for patients receiving mechanical circulatory support.
• Construct safe and effective drug therapy regimens for patients receiving extracorporeal membrane oxygenation support.
• Assess effectiveness of treatment plans for patients with complications of durable left ventricular assist device therapy.

ACPE Number: 0217-9999-26-100-H01-P

Acute Coronary Syndrome

• 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 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

• 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.

ACPE Number: 0217-9999-26-101-H01-P

Pulmonary Arterial Hypertension

• 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

• 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.

ACPE Number: 0217-9999-26-102-H01-P

Translation of Evidence into Practice

• 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 various types of outcomes and study designs in cardiovascular studies.

Principles of Cardiology Pharmacy Practice Administration

• 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.

Supplemental material

• Pharmacogenomics of Cardiovascular Disease

Full Faculty Bios

*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 people in control of the activity content have relevant financial relationships: 

FACULTY DISCLOSURES  

REVIEWER DISCLOSURES 

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.