SGLT-2 Inhibitors
HFpEF Treatment Options
As a clinical pharmacy specialist, you will get questions about managing heart failure with PRESERVED ejection fraction (HFpEF), based on new guidance. Over half of HF patients have HFpEF, with an ejection fraction of 50% or higher. But treatment of HFpEF is still less clear-cut than heart failure with REDUCED ejection fraction (HFrEF) , since HFpEF data are less rob…
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Pts W/ DM and HF
Carvedilol is better than Metoprolol for HF and DM patients
As a clinical pharmacy specialist, cardiologists will ask you for your recommendations on which beta-blockers are better, carvedilol or metoprolol in patients with heart failure and diabetes . There is tantalizing evidence that carvedilol MIGHT be better. But the truth is not so clear. The first head-to-head comparison sugges…
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SGLT-2 Inhibitors
Add SGLT2 inhibitors to your HF patients
As a clinical pharmacist, you will need to ensure appropriate use of SGLT2 inhibitors (empagliflozin, etc), as more hospitals add these medications to formulary. It’s partly because guidelines for heart failure with reduced ejection fraction (HFrEF) now recommend “quad therapy” adding an SGLT2 inhibitor (SGLT2i) to triple therapy , regardless of diabetes. …
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Pts W/ DM and HF
Best DIET in heart failure
As a nutrition support pharmacist, you should advise on the best diet for your patients with heart failure. Previously, the focus on preventing and treating heart failure was to restrict excess sodium intake in order to prevent excess fluid load. While sodium control is still important, macronutrient nutrition may be more important in prevention than previously thou…
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HFrEF Treatment
How to DOSE medications for systolic heart failure
As a cardiovascular pharmacist, you will be asked more how to dose medications for systolic heart failure. Many cardiac conditions rely on a key "number" to determine drug efficacy. For example, blood pressure guides hypertension treatment and LDL levels guide dyslipidemia therapy . But there's no key number to measure efficacy for heart failure . I…
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HFrEF Treatment
Keep NEW heart failure guidelines in mind
As a clinical pharmacist, you should put NEW heart failure guidelines in perspective . Big changes in guidelines will lead to debate about managing heart failure with reduced ejection fraction (HFrEF). We’re used to “triple therapy” for HFrEF; an ACEI or ARB , evidence-based beta-blocker (carvedilol, etc), and aldosterone antagonist (spironolac…
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SGLT-2 Inhibitors
Know the role of empagliflozin (JARDIANCE) in heart failure with preserved ejection fraction
As a pharmacist, you will hear buzz about the role of Jardiance (empagliflozin) in managing heart failure with PRESERVED ejection fraction (HFpEF) . This is in addition to the growing evidence showing benefit of SGLT2 inhibitors in heart failure with REDUCED ejection fraction (HFrEF) . But over half of HF patients have HFpEF, and to date, treatment options for HFpE…
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Spironolactone
Managing diastolic or preserved ejection fraction heart failure (HFpEF)
How to treat "DIASTOLIC" heart failure or heart failure with a PRESERVED ejection fraction (HFpEF)? Over HALF of heart failure patients have this type, which is due to a stiff left ventricle that can't adequately fill. This is different from "SYSTOLIC" heart failure or heart failure with a REDUCED ejection fraction (HFrEF). These patients have…
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SGLT-2 Inhibitors
SGLT2 inhibitors for patients without diabetes
Recently, more patients withOUT diabetes will use SGLT2 inhibitors ( Invokana, Forxiga, etc ) for heart failure or kidney disease . That's because growing evidence suggests these medications may improve outcomes when added to standard therapy. In heart failure with reduced ejection fraction (HFrEF), adding Jardiance (empagliflozin) over 16 months prevents hospi…
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Pts W/ DM and HF
Consider heart failure when weighing medications for diabetes
HEART FAILURE is a frequent and often fatal complication of type 2 diabetes and there will be more focus on how this affects medication choices. Consider whether your patient also has heart failure when evaluating diabetes medications, since some may help or harm. Medications with potential benefit Continue to recommend metformin first, it's linked to l…
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