Basics in Cardiology Pharmacy Certificate

Introduction to Cardiology Pharmacy and Primary Prevention of Cardiovascular Disease
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• Given a diagram of the heart, identify the major vessels, valves, and circulation pathway.
• Define the terms preload, afterload, ejection fraction (EF), stroke volume (SV), cardiac output (CO), cardiac index (CI), mean arterial pressure (MAP), and pulmonary capillary wedge pressure (PCWP), and explain the relationships between each parameter.
• Describe the pathophysiology of atherosclerosis, ischemia, and cardiac remodeling.
• Identify the clinical presentations of a patient with angina and/or ischemic heart disease.
• Compare cardiovascular risk assessment tools.
• Recommend appropriate lifestyle interventions to prevent cardiovascular disease.
• Summarize clinical guideline recommendations for primary prevention of cardiovascular disease. 

Assessment of the Cardiovascular System
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• Explain the six steps for accurately measuring blood pressure according to current best practices.
• Describe methods for determining heart rate and assessing heart rhythm, volume status, and cardiac output.
• Compare and contrast the signs and symptoms of atrial fibrillation, coronary artery disease, heart failure, and venous thromboembolism.
• Analyze laboratory data to assess a patient’s risk for atherosclerotic cardiovascular disease, determine the severity of a patient’s cardiac condition, and/or develop a therapeutic plan. 

Hypertension
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• Explain the clinical rationale for treating hypertension and evidence supporting long-term antihypertensive drug therapy.
• Assign the correct blood pressure category as defined by current guidelines based on a patient’s blood pressure.
• Identify an appropriate patient-specific blood pressure goal according to current guidelines.
• Recommend lifestyle modifications to lower blood pressure according to current guidelines.
• Select antihypertensive drug therapy for patients with hypertension based on race and compelling indications according to current guidelines.
• Summarize the rationale for the use of combination antihypertensive drug therapy.
• Compare drug therapy options for resistant hypertension.
• Develop monitoring plans for patients with hypertension.
• Recommend drug therapy regimens for patients with resistant hypertension.
• Define hypertensive urgency and hypertensive emergency, including the differences in diagnostic criteria.
• Calculate a mean arterial pressure.
• Recommend goals and management strategies for blood pressure lowering in the treatment of hypertensive urgency and hypertensive emergency.
• Design drug therapy plans for patients with hypertension, including the use of combination antihypertensives as appropriate. 

Dyslipidemia
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• Identify common lipid disorders.
• Recommend lifestyle and pharmacotherapy interventions for dyslipidemia.
• Differentiate treatment approaches for primary vs. secondary atherosclerotic cardiovascular disease (ASCVD) prevention.
• Compare clinical guideline treatment goals and recommendations.
• Explain a safe and effective monitoring plan for dyslipidemia pharmacotherapy. 

Stable Ischemic Heart Disease
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• Explain the initial physical and laboratory assessments, diagnosis, and risk assessment for patients with stable ischemic heart disease.
• Differentiate between stable and unstable angina.
• Recommend appropriate lifestyle modification such as smoking cessation, weight management, diet, and physical activity to reduce cardiovascular risk in patients with stable ischemic heart disease.
• Evaluate the role of aspirin and other antiplatelet agents for prevention of cardiovascular events in patients with stable ischemic heart disease.
• Recommend anti-anginal therapy in a patient with stable ischemic heart disease.
• Develop a pharmacotherapy plan to optimize blood pressure and heart rate in patients with stable ischemic heart disease.  

Acute Coronary Syndrome
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• Explain the initial physical and laboratory assessment, diagnosis, and risk assessment for patients with acute coronary syndrome (ACS).
• Differentiate among unstable angina, non-ST-segment elevation myocardial infarction, and ST-segment elevation myocardial infarction.
• Recommend appropriate initial pharmacotherapy options in patients with acute coronary syndrome (ACS).
• Evaluate initial anticoagulation therapy options in patients presenting with acute coronary syndrome (ACS).
• Compare antiplatelet pharmacotherapy options in patients with acute coronary syndrome (ACS).
• Select an appropriate treatment duration for dual antiplatelet therapy to minimize both ischemic and bleeding risk in patients presenting with ACS.
• Develop a pharmacotherapy plan to reduce cardiovascular risk in patients with ACS. 

Heart Failure
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• Identify appropriate screening and diagnostic studies necessary to manage patients with suspected heart failure.
• Evaluate patient symptoms and history to appropriately define and classify heart failure.
• Develop a guideline-directed medical therapy (GDMT) regimen to treat heart failure with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF).
• Monitor a GDMT regimen to prevent harm and improve heart failure outcomes.
• Identify medications that should be avoided in patients with heart failure.
• Assign patients with acute decompensated heart failure (ADHF) to the appropriate hemodynamic subgroup based on clinical presentation and hemodynamic parameters.
• Develop a patient-specific drug therapy plan for a patient with acute decompensated heart failure.
• Apply strategies for reducing hospital readmission rates and improving outcomes in patients with heart failure. 

Venous Thromboembolism
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• Discuss patient risk factors and current diagnostic tools for venous thromboembolism (VTE).
• Design an appropriate antithrombotic treatment regimen for venous thromboembolism (VTE) patients.
• Compare and contrast anticoagulant treatment options for venous thromboembolism (VTE) patients in special populations including obesity, renal dysfunction, and cancer. 

Peripheral Artery Disease
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• Assess a patient at risk of lower extremity peripheral arterial disease (PAD) for signs and symptoms.
• Summarize the data necessary for diagnosing lower extremity peripheral arterial disease (PAD) and determining the severity of disease.
• Design a treatment plan for a patient with lower extremity PAD based on the presence or lack of symptoms.
• Evaluate the safety and efficacy of a treatment regimen for a patient with lower extremity PAD. 

Ischemic Stroke and Transient Ischemic Attack
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• Compare and contrast ischemic stroke and transient ischemic attack (TIA).
• Recommend a treatment plan for a patient with ischemic stroke or TIA.
• Differentiate between treatment options for acute management and secondary prevention of ischemic stroke and TIA.
• Apply evidence from antiplatelet and lipid-lowering trials in stroke and TIA patients to support drug therapy recommendations.
• Justify recommended treatment plans for patients with ischemic stroke or TIA.
• Identify future directions for research and patient care in ischemic stroke and TIA. 

Arrhythmias and Advanced Cardiac Life Support
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• Assess patients with atrial fibrillation to guide the development of evidence-based pharmacologic recommendations.
• Recommend evidence-based pharmacologic therapy for either rate or rhythm control in patients with atrial fibrillation.
• Evaluate the risks and benefits of anticoagulation for stroke prevention in patients with atrial fibrillation, taking patient-specific factors into consideration.
• Recommend evidence-based pharmacologic therapy to reduce the risk of stroke in patients with atrial fibrillation.
• Develop monitoring plans for patients with atrial fibrillation receiving pharmacologic therapy, taking adverse drug reactions and interactions into consideration.
• Assess patients with cardiac arrhythmias to guide the development of evidence-based pharmacologic recommendations.
• Analyze individual risk factors in patients with cardiac arrhythmias to assist in the differential diagnosis of cardiac arrest.
• Select appropriate pharmacologic therapy for cardiac arrhythmias based on patient-specific information and Advanced Cardiac Life Support (ACLS)-guided therapies.
• Select appropriate pharmacologic therapy for cardiac arrhythmias based on patient-specific information and Pediatric Advanced Life Support (PALS)-guided therapies. 

Cardiovascular Disease in Special Populations
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• Explain how management of cardiovascular diseases in special populations may differ from the general population.
• Discuss therapeutic considerations when managing cardiovascular diseases in special populations.
• Apply primary literature and clinical guidelines to the management of cardiovascular diseases in special populations.
• Select appropriate therapeutic options in the management of cardiovascular diseases within special populations. 

Social Determinants of Health and Cardiovascular Disease
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• Define social determinants of health and their relationship to cardiovascular disease.
• Select screening approaches and tools to identify social determinants of health and their impact on patients with cardiovascular disease.
• Describe the relevance of addressing and managing social determinants of health in patients with cardiovascular disease. 

Pharmacogenomics
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• Describe the approach for genetic testing of patients with suspected and confirmed inherited cardiovascular disease.
• Select clinical resources utilized to translate pharmacogenetic test results that can be used to guide drug therapy recommendations.
• Identify cardiovascular medications and gene-drug pairs with higher levels of evidence that support the use of pharmacogenetic testing.
• Interpret ABCG2, CYP2C9, CYP2C19, VKORC1, and SLCO1B1 genotypes to guide the selection and dosing of cardiovascular medications.
• Explain technical and social matters that may impact the usefulness of pharmacogenetic testing. 

Ambulatory Care and Inpatient Roles in Cardiology Pharmacy
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• Describe traditional and nontraditional education, training, and credentialing pathways for cardiology-focused clinical pharmacists.
• Identify typical clinical activities in the inpatient and outpatient practice environments that comprise clinical pharmacy services for cardiology-focused pharmacists.
• Evaluate key evidence regarding the benefit of cardiology-focused activities by clinical pharmacists.
• Identify key regulatory, quality, and public health initiatives which influence clinical pharmacy services provided by cardiology-focused pharmacists.