Dual Antiplatelet Therapy
DAPT duration for patients at HIGH bleeding risk
As a cardiovascular pharmacist, you will hear debate about shorter dual antiplatelet therapy (DAPT) durations after a stent in acute coronary syndrome (ACS) . The standard has been DAPT with aspirin AND a P2Y12 inhibitor ( clopidogrel , prasugrel, or ticagrelor ) for 12 months, with the option to extend for those at high thrombotic and low bleeding risk. …
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Nitrates
Optimize therapy for angina
As a hospital pharmacist, you will get questions about how to optimize therapy for angina when the maximum tolerated dose of a beta-blocker isn't enough. Follow these steps... Use a calcium channel blocker (CCB) . SWITCH from a beta-blocker to verapamil ( Isopten , initial 80 mg TID to QID; max 480 mg/day, divided) or diltiazem ( Altiazem , initial 120 to 18…
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Myocardial Infarction
Use "ABCDs" to optimize medications for stable coronary artery disease
Recent evidence suggests coronary stents don't improve chest pain more than optimal medications in patients with stable coronary artery disease. Remember these "ABCDs: A- antiplarelet; B- blood pressure; C- cholesterol; D- diabetes; S- symptom relief" to help manage patients with angina or who've had a heart attack more than a year ago... Anti…
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