Primary Prevention of Cardiovascular Disease and Public Health

Stable Atherosclerotic Disease

1. Recommend patient-specific pharmacologic therapy for the management of chronic coronary disease (CCD).  
2. Differentiate between the antianginal options for a patient with refractory angina.  
3. Develop an optimal pharmacologic regimen and monitoring plan for patients with peripheral arterial disease (PAD) considering individual patient symptomatology and characteristics.  
4. Develop an evidence-based pharmacologic regimen for secondary prevention of non-cardioembolic ischemic stroke and transient ischemic attack (TIA).
5. Recommend risk factor modification strategies to prevent a recurrent event for patients with CCD, PAD, and non-cardioembolic ischemic stroke/TIA.  

Anticoagulation

1. Recommend a patient-specific pharmacotherapy plan to reduce the risk of stroke in patients with atrial fibrillation (AF).​
2. Compose an evidence-based pharmacotherapy plan for preventing and treating venous thromboembolism (VTE).​
3. ​Analyze the need for anticoagulation in patients with AF or VTE.
4. ​Propose appropriate reversal strategies for patients at risk of bleeding or actively bleeding while receiving anticoagulation therapy.​
5. ​Construct an appropriate selection and dosing of anticoagulant therapy on the basis of patient specific factors and drug interactions.​
6. Evaluate literature and clinical implications of data for patients receiving anticoagulant agents.

Arrhythmias

1. Determine the QT/QTc interval using an electrocardiogram (ECG) rhythm strip.
2. Assess risk factors and goals of therapy for atrial and ventricular arrhythmias.
3. Compare and contrast the mechanisms of action of antiarrhythmic drugs.​
4. Identify opportunities to improve transitions of care for patients receiving antiarrhythmic drugs.
5. Given a patient with an arrhythmia, recommend an evidence-based pharmacotherapy plan.
6. Evaluate common and important drug-drug interactions and adverse effects of antiarrhythmic drugs.

Drug-Induced Cardiovascular Disease and Drugs to Avoid in Cardiovascular Disease

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

Chronic Heart Failure

1. Given a patient with heart failure (HF), describe the classifications, staging, clinical presentation, etiologies, and diagnostic considerations.
2. Describe the pathophysiology of HF, focusing on the role that neurohormonal and other vasoactive agents play in HF progression.
3. Given a patient with chronic HF, devise an appropriate pharmacologic and nonpharmacologic therapeutic plan, with an emphasis on guideline-directed medical therapy and management.
4. Given a patient with chronic HF and several comorbidities, devise an appropriate evidence-based pharmacotherapy plan addressing specific comorbidities related to HF.
5. Interpret clinical trial results to determine the utility of pharmacologic and nonpharmacologic therapies in the treatment of heart failure.

Decompensated Heart Failure

1. 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.
2. Design an initial pharmacotherapeutic treatment and monitoring plan for a patient with decompensated HF based on hemodynamic subset.
3. Devise a modified treatment and monitoring plan in a patient with decompensated HF and diuretic resistance.
4. 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.
5. List strategies for reducing the risk of HF readmission among patients recovering from decompensated HF.

Heart Transplant and Mechanical Circulatory Support

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

Acute Coronary Syndrome

1. Distinguish between reperfusion strategies for acute coronary syndrome (ACS): ST-segment elevation myocardial infarction (STEMI) and nonST-segment elevation (NSTE) ACS.
2. ​Devise a pharmacotherapeutic treatment plan for a patient with STEMI undergoing primary percutaneous coronary intervention (PPCI) and for a patient with NSTE-ACS undergoing revascularization or medical management.​
3. Differentiate between the best possible pharmacologic options for preventing thrombotic events in the acute management of ACS.
4. Analyze differences in evidence, pharmacology, pharmacokinetics, drug-drug interactions, monitoring, and adverse events between antithrombotic therapies used in ACS management.​
5. Devise an individualized evidence-based treatment plan for patients in need of secondary prevention post-ACS, including mortality-reducing therapies.

Cardiovascular Emergencies

1. Choose appropriate management pathways/treatment for a patient with cardiac arrest according to patient presentation.​​​
2. Differentiate between the various categories of shock.​
3. ​​Select the optimal management strategies for the various types of shock.​​
4. Construct a pharmacotherapy regimen for the various hypertensive crises.​​
5. ​​Select an appropriate management plan for a patient presenting with acute aortic syndrome.​​
6. Design a pharmacotherapy plan for the management of acute ischemic stroke.​​

Pulmonary Arterial Hypertension

1. Describe the classification of pulmonary hypertension and implications for treatment.
2. 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.
3. Define treatment goals for the management of PAH.
4. Outline targeted medications for PAH, including indications, dosing, monitoring, and their place within current treatment algorithms.
5. Identify common adverse effects and drug interactions associated with PAH medications.
6. Highlight appropriate treatment approaches for the management of decompensated PAH.
7. Design a treatment plan for a patient with PAH.

Specialized Topics in Cardiovascular Disease

1. Recommend empiric antibiotic therapy for patients with suspected infective endocarditis (IE).
2. Develop a therapeutic plan regarding medication therapy for patients with IE or patients requiring prophylactic therapy for IE prevention.
3. Identify patients who require IE prophylactic therapy.
4. Develop a treatment plan for patients with pericarditis.
5. Recommend appropriate therapy for patients with myocarditis.
6. Plan a medication therapy regimen for patients with valvular heart disease.

Translation of Evidence into Practice

1. Identify different types of data (nominal, ordinal, continuous) to determine the appropriate type of statistical test (parametric vs. nonparametric).​
2. Select appropriate statistical tests based on the anticipated sample distribution, data type, and study design.​
3. ​Identify the most appropriate study design to answer a given research question.​
4. ​Describe the key tenets of internal and external validity of cardiovascular-related trials.
5. Describe the advantages and disadvantages of various types of outcomes and study designs in cardiovascular studies.​

Principles of Cardiology Pharmacy Practice Administration

1. Distinguish policies, procedures, and clinical protocols related to the medication use process.
2. Identify formulary management activities to improve the prescribing of safe, effective, and affordable treatments in an organization.
3. Describe strategies to plan for and respond safely and efficiently to drug product shortages.
4. 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.
5. Describe national quality initiatives and regulatory requirements aimed at improving health care delivery and patient health outcomes.
6. Define pharmacoeconomic principles and be able to apply them to patient care.
7. Compare a medication error, adverse drug event (ADE), adverse drug reaction (ADR), and preventable ADE.
8. Analyze an ADE reporting program, including committee structure, committee reporting mechanisms, and methods of detecting, reporting, and managing ADEs.