Although beta blockers are considered a fundamental therapy for patients with heart failure (HF), questions remain on how to manage them these medications in patients presenting with decompensation requiring intravenous inotropic therapy. In this post, we will provide some insights on managing the chronic beta blockade and intravenous inotropic therapy when used concomitantly in a decompensated HF patient.
Obstructive sleep apnea screening: what every pharmacist should know
Obstructive sleep apnea (OSA) is a risk factor for several cardiac conditions and is a common chronic condition. It is important for providers to screen patients for OSA so they can undergo diagnostic testing, and potentially treatment. This piece will review the risk factors for OSA, screening and the association with cardiac conditions such as heart failure, atrial fibrillation and bradycardia.
Understanding the IMPACT(-HF) of Initiating GDMT Prior to Discharge
Although admitted patients with heart failure often have acute medical issues (e.g. acute kidney injury, acute decompensation) that may preclude them from certain therapies, many are appropriate candidates for guideline-directed medical therapy (GDMT) before they leave the hospital. This blog discusses the importance of initiating GDMT prior to discharge, whenever possible.
6 Takeaways from the 2019 Primary Prevention Guideline
There has been a wealth of information in the literature over the past few years about various strategies to prevent cardiovascular disease. Many have been highly anticipating the new primary prevention recommendations from the American College of Cardiology/American Heart Association for guidance on how to apply all of this new evidence. The guidelines have recently been released! A summary of the key takeaways from the Primary Prevention guideline are provided in this blog.
4 Mistakes You Could Be Making with Loop Diuretics
Despite being the mainstay of therapy, questions remain as to how to properly use loop diuretics in patients with acute decompensated heart failure (ADHF). In this post, we’ll cover four of the most common mistakes with using loop diuretics in this population.
AC in ESRD (Part III): Warfarin Over Apixaban for Patients with Atrial Fibrillation and End Stage Renal Disease
Part III of this three part series focuses on the role of warfarin in end stage renal disease (ESRD). Is it time to retire warfarin for anticoagulation in patients with ESRD and atrial fibrillation (AF)? Are there supporting data for warfarin in patients with ESRD? How does it compare to apixaban? Check out the blog for full details and answers to these questions.
4 Updates Every Clinician Should Know About the 2019 AF Guidelines
The highly anticipated focused update of the 2014 atrial fibrillation guideline incorporates modified recommendations based on evidence from several recent publications. This blog will detail the four most important updates from the guideline, including a brief discussion of the data influencing these changes.
AC in ESRD (Part II): Apixaban Over Warfarin for Patients with Atrial Fibrillation and End Stage Renal Disease
Part II of this three part series focuses on apixaban in end stage renal disease. Is it safe? How does it compare to warfarin? What dose should you use? Check out the blog for full details and answers to these questions.
AC in ESRD (Part 1): First, Do No Harm – No Anticoagulation in Patients with End Stage Renal Disease and Atrial Fibrillation
Selecting the best anticoagulation strategy for patients with end stage renal disease and atrial fibrillation remains controversial. In this three part series, we will explore potential strategies that seek to balance the risk of stroke with adverse effects in patients with end stage renal disease and atrial fibrillation. In Part 1 of this series, we will discuss the risks of anticoagulation and provide a compelling argument for avoiding anticoagulation. The role of direct oral anticoagulants and warfarin in this patient population will be reviewed in Parts 2 and 3, respectively.
Post-TAVR Antithrombotic Therapy: What To Do When No One Knows What To Do.
Transcatheter aortic valve replacement (TAVR) has proven to be an effective treatment option for patients with severe aortic stenosis at intermediate-high risk for complications with surgical aortic valve replacement. In spite of the growing popularity of TAVR, the optimal antithrombotic regimen remains unknown. This blog outlines current guideline recommendations for post-TAVR antithrombotic therapy and gives guidance on how to handle special populations and patient-specific factors.