An Evening with your Pharmacists MENDED HEARTS. Specialty Practice Pharmacist Electrophysiology...

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An Evening with your Pharmacists MENDED HEARTS

Transcript of An Evening with your Pharmacists MENDED HEARTS. Specialty Practice Pharmacist Electrophysiology...

Page 1: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

An Evening with your Pharmacists

MENDED HEARTS

Page 2: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Specialty Practice Pharmacist Electrophysiology

MIKE BOYD, PHARM D

Page 3: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

ANTIARRHYTHMIC DRUGS

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Name (Brand Name)Quinidine (Quinaglute®, Quinidex®)

Disopyramide (Norpace®)

Mexiletine (Mexitil®)

Flecainide (Tambocor®)

Propafenone (Rythmol®, Rythmol SR®)

Amiodarone (Cordarone®, Pacerone®)

Dofetilide (Tikosyn®)

Dronedarone (Multaq®)

Sotalol (Betapace®, Betapace AF®)

ANTIARRHYTHMIC DRUGS

Page 5: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Specialty Practice Pharmacist Cardiology/Cardio-thoracic Surgery

KEVIN KISSLING, PHARM D

Page 6: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Commonly referred to as “blood thinners”Used for 2 primary reasons:

1. Prevent a new clot from forming Atrial Fibrillation Other high risk states

2. Treat an existing clot Pulmonary Embolism (PE) Deep Vein Thrombosis (DVT)

ANTICOAGULANTS

Page 7: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Drug of choice for more than 50 yearsRequires monitoring of PT/INR

Reflects level of anticoagulationAllows for daily dose to be adjusted

Effect can be reversed with Vitamin KDiet can effect control

Key is consistency, not avoidance

WARFARIN (COUMADIN®)

Page 8: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Dabigatran (Pradaxa®)Must be taken twice dailyMust be stored in original packaging

Rivaroxaban (Xarelto®)Once daily dosingShould be taken with the evening meal

Apixaban (Eliquis®)

THE NEW ANTICOAGULANTS

Page 9: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Take as directedAlert healthcare workers you are taking

Have a plan for invasive proceduresScreen for drug interactionsSafety in emergent situations

Be mindful of signs of bleedingBlood in urine, stoolSeek medical attention for persistent bleeding

TIPS FOR ALL ANTICOAGULANTS

Page 10: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Specialty Practice Pharmacist Acute Coronary Syndromes

DANIELLE BLAIS, PHARM D

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Leading cause of death in both men and women

Risk factors AgeSmokingDiabetesHigh blood pressureHigh cholesterol

CORONARY ARTERY DISEASE

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CORONARY ARTERY DISEASE

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To keep your Stent openAspirin 81 mg daily

FOR LIFEClopidogrel (Plavix) 75 mg daily

Depends on the type of stent Side effects- bleeding Take your medication daily Do not stop taking unless directed by your

Cardiologist

PROTECT YOUR STENT

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Specialty Practice Pharmacist Cardiology/Cardio-thoracic Surgery

PAMELA BURCHAM, PHARM D

Page 15: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Makes you at risk for a heart attackGood cholesterol – HDLBad cholesterol – LDLStatins :

Atorvastatin (Lipitor)Lovastatin (Mevacor)Simvastatin (Zocor)Rosuvastatin (Crestor)Pravastatin (Pravachol)

HIGH CHOLESTEROL

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Side effects:Muscle pains Stomach bloating

Drug interactions : Amiodarone Blood thinnersSeizure medications Antidepressants

WHAT TO WATCH OUT FOR

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Specialty Practice Pharmacist Heart Failure

KERRY PICKWORTH, PHARM D

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HEART FAILURE

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Drugs which make the heart pump more effectively Enalapril, Lisinopril, Valsartan (Diovan), Losartan (Cozaar)

Metoprolol XL (Toprol XL), Carvedilol (Coreg) Drugs which improve the symptoms

Diuretics ( water pills ) Furosemide (Lasix) , Torsemide (Demadex)

DRUGS USED TO TREAT

Page 20: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Weigh yourself daily If weight ↑ by 2-3 lbs /day or 5 lbs /wkWatch you liquid intake Restrict your salt intake May need potassium and magnesium

supplements

WATER PILLS

Page 21: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Cardiology Pharmacy Resident

SAJNI PATEL, PHARM D

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Acetaminophen (Tylenol)Dose

325-650 mg every 4-6 hours

Maximum of 4,000 mg per day

AspirinDose

325-650 mg every 4-6 hours

Side Effects Bleeding Upset stomach

ACHES, PAINS, AND FEVERS

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Non-Steroidal Anti-inflammatory Drugs (NSAIDs) Ibuprofen (Motrin, Advil) Naproxen (Aleve)

DO NOT USE

Page 24: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D.

Why?Damages the kidneys Increased risk of heart attack and strokeCan increase blood pressureCan interact with many medications, including: Warfarin (Coumadin) Aspirin Clopidogrel (Plavix)

AVOID NSAIDS

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Cardiology Pharmacy Resident

KRISTEN TASCA, PHARM D

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Chlorpheniramine (Coricidin HBP)Variety of available formulations

COUGH AND COLD

Guaifenesin (Robitussin)Variety of available formulations

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Pseudoephedrine ProductsSudafedAdvil Cold and SinusDayQuil-DNyQuil-DClaritin-DMucinex-D

Phenylephrine Sudafed PEDayQuilNyquil Sinus

DO NOT USE

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CHECK THE LABELS

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Specialty Practice Pharmacist Cardio-thoracic Surgery

ERIK ABEL, PHARM D

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Be your own best advocateAllergies?Stopped meds ...Why?New medication?

Risks? Interactions?Adherence? Cost?

Be compliant for the best outcome

HOW CAN I HELP MYSELF?

Time

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Coordinate your careTalk to all your healthcare providersPlanning for procedures?Refills?Ask questions

Primary Care Physician, Cardiologist Pharmacist Dentist

HOW CAN I HELP MYSELF