Cardiology Pharmacy Specialty Review Course for Recertification + RECERT EXAM Package (Cert # L229236)

The American College of Clinical Pharmacy and American Society of Health-System Pharmacists are accredited by the Accreditation Council for Pharmacy Education as providers of continuing pharmacy education.

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.

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. 

* Please note: Review Course for Recertification may only be completed for recertification credit up to two times, in nonconsecutive years, during the 7-year recertification cycle.

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

Primary Prevention of Cardiovascular Disease and Public Health
ACPE #: 0217-9999-22-094-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 #: 0217-9999-22-095-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.
• 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 #: 0217-9999-22-096-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 #: 0217-9999-22-097-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 #: 0217-9999-22-098-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 #: 0217-9999-22-099-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 #: 0217-9999-22-100-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 #: 0217-9999-22-101-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.

Acute Decompensated Heart Failure
ACPE #: 0217-9999-22-102-H01-P
• Classify a patient with acute decompensated heart failure (ADHF) 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 ADHF based on hemodynamic subset.
• Devise a modified treatment and monitoring plan in a patient with ADHF and diuretic resistance.
• Compare and contrast the use of intravenous (IV) vasodilators and positive inotropes in the treatment of ADHF, and among the agents within each drug class.
• List strategies for reducing the risk of heart failure (HF) readmission among patients recovering from ADHF.

Heart Transplant and Mechanical Circulatory Support
ACPE #: 0217-9999-22-103-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 #: 0217-9999-22-104-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 #: 0217-9999-22-105-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 #: 0217-9999-22-106-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 #: 0217-9999-22-107-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 #: 0217-9999-22-108-H99-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 #: 0217-9999-22-109-H04-P
• Develop 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 be capable of managing the MUE process.
• Describe national quality initiatives and regulatory requirements aimed at improving health care delivery and patient health outcomes.
• Review pharmacoeconomic principles and their application to patient care.
• Compare a medication error, adverse drug event (ADE), adverse drug reaction (ADR), and preventable ADE.
• Design 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, BCPS
Associate Professor of Pharmacy Practice
Wilkes University
Wilkes-Barre, Pennsylvania

Johnathan D. Cicci, Pharm.D., BCPS, BCCP, CPP
Clinical Pharmacy Specialist, Cardiology
University of North Carolina Medical Center
Chapel Hill, North Carolina

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

Shannon W. Finks, Pharm.D., FCCP, BCPS, BCCP, AHSCP-CHC
Professor of Clinical Pharmacy and Translational Science
University of Tennessee College of Pharmacy
Memphis, Tennessee

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

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

Tracy E. Macaulay, Pharm.D., FCCP, FACC, BCCP
Clinical Associate Professor
University of Kentucky College of Pharmacy
Lexington, Kentucky

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

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

*Content matter experts

Mary Blanton Covell, Pharm.D., MPH, BCPS, BCCP
Jessica M. Casey, Pharm.D., BCPS, BCCP
Maya R. Chilbert, Pharm.D., BCCP
Jackoline M. Costantino, Pharm.D., BCCP
Anne Denham, Pharm.D., BCPS, (AQ-Cardiology)
Sandeep Devabhakthuni, Pharm.D, BCPS, BCPP
Augustus Hough, Pharm.D., BCPS, BCCP
Cynthia A. Jackevicius, BScPHm, Pharm.D., MSc, BCPS, BCCP
Kazuhiko Kido, Pharm.D., BCPS, BCCP
Joel C. Marrs, Pharm.D., MPH, BCACP, BCCP, BCPS, CHC, CLS
Kristin E. Montarella, Pharm.D., BCPS, BCPP
Kari L. Olson, Bsc(Pharm), Pharm.D., FCCP, BCPS
Adam J. Smith, Pharm.D., BCPS, BCCCP
Elisabeth M. Wang, Pharm.D., BCCP
Barbara S. Wiggins, Pharm.D., BCPS, BCCP, BCCCP
Kevin M. Wohlfarth, Pharm.D., BCPS, BCCCP, BCCP

Rebekka Adamson, Pharm.D., BCCP
Fatimah Alshehri, Pharm.D., BCPS, BCCP
Nicholas Barker, Pharm.D., BCCP, BCCCP
Daniel Blee, Pharm.D., BCPS, BCCP
Amy Lynne Brokenshire, Pharm.D., BCPS, BCCP, BCCCP, CACP
Franco Cheng, MClinPharm, BCCP, BCPS
Allison Chidester, Pharm.D., BCCP
Katherine Crawford, Pharm.D., BCCP
Albert Czachor, Pharm.D., BCCP
Lindsay Davis, Pharm.D., BCPS, BCCP, TTS, ASH-CHC
Paul Dobesh Pharm.D., FACC, FAHA, FCCP, BCPS, BCCP
Rachael Eaton, Pharm.D., BCCP, MBA
Emad Elkholy, Pharm.D., BCCCP, BCCP
Amr Fahmy, BCCP, MSc
Lindsey Federle, Pharm.D., BCCP, BCPS
Aidan Fischer, Pharm.D., BCCP
Wendy Gabriel, Pharm.D., BCPS, BCCP
Lindsey Greiner, Pharm.D., BCPS, BCCP
Awatif Hafiz, Pharm.D., BCCP
Genevieve Hale, Pharm.D., BCPS, BCCP, CPh
Carol Heunisch, Pharm.D., BCPS, BCCP
Christine Ji, Pharm.D., BCPS, BCCP
Dareen Kanaan, Pharm.D., R.Ph, BCCP
Heather Kertland, BScPhm, Pharm.D., BCCP
Gillian Leung, Pharm.D., BCCP
Brian Lindvahl, Pharm.D., BCPS, BCCP
Melanie Madorsky, Pharm.D., BCPS, BCCP, BCCCP
Emad Makramalla, BCPS, BCCP
Noha Mahmood Morsi, BCCP
Emily McElhaney, Pharm.D., BCCP
Richard Mullvain, R.Ph., BCCP, BCPS (AQ-Cardiology)
Helen Ngo, BPharm, BCCP, BCPS
Bobbie Nguyen, Pharm.D.
Priyam Patel, Pharm.D., BCCP
Danielle Porter, Pharm.D.
Richard Rovelli, Pharm.D.
Joshua Sessions, Pharm.D., BCCP
David Silva, Pharm.D., BCPS, BCCP
Andrew Smith, Pharm.D., BCCP, BCPS, FCCP
Brendan Sorrento, Pharm.D., BCPS, BCCP
Azita Talasaz, Pharm.D., BCPS, BCCP
Brandi Thoma, Pharm.D., BCPS, BCCP
Kristin Watson, Pharm.D., BCCP
Kathryn Weber, Pharm.D., BCPS, BCCP
Brittany Wheeler, Pharm.D., MPH, BCACP, BCCP
Barbara Wiggins, Pharm.D., BCPS, BCCP, BCCCP
Katie Willenborg, Pharm.D., BCPS, BCCP
Ming Yang, Pharm.D., 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. 

• Consultant: James C. Coons (Pfizer–Bristol Myers Squibb Alliance, Alnylam Pharmaceuticals); Paul P. Dobesh (Pfizer–Bristol Myers Squibb Alliance, Janssen Pharmaceuticals); Steven P. Dunn (Abiomed); Stormi E. Gale (Pharmacosmos); Douglas L. Jennings (Abiomed, Novartis Pharmaceuticals)
• Employee: Dustin D. Spencer (Cardinal Health)
• Grant Funding/Research Support: James C. Coons (Heart Rhythm Society, Pfizer–Bristol Myers Squibb Alliance, United Therapeutics); Stormi E. Gale (United Therapeutics)
• Reviewer: Stormi E. Gale (Actelion)
• Speaker’s Bureau: Stormi E. Gale (Kiniksa); Douglas L. Jennings (Alexion 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.