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An Evening with your Pharmacists MENDED HEARTS

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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

Page 4: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Page 11: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

Leading cause of death in both men and women

Risk factors AgeSmokingDiabetesHigh blood pressureHigh cholesterol

CORONARY ARTERY DISEASE

Page 12: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

CORONARY ARTERY DISEASE

Page 13: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Page 14: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Page 16: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

Side effects:Muscle pains Stomach bloating

Drug interactions : Amiodarone Blood thinnersSeizure medications Antidepressants

WHAT TO WATCH OUT FOR

Page 17: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

Specialty Practice Pharmacist Heart Failure

KERRY PICKWORTH, PHARM D

Page 18: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

HEART FAILURE

Page 19: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Page 22: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Page 23: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Page 25: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

Cardiology Pharmacy Resident

KRISTEN TASCA, PHARM D

Page 26: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

Chlorpheniramine (Coricidin HBP)Variety of available formulations

COUGH AND COLD

Guaifenesin (Robitussin)Variety of available formulations

Page 27: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Phenylephrine Sudafed PEDayQuilNyquil Sinus

DO NOT USE

Page 28: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

CHECK THE LABELS

Page 29: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

Specialty Practice Pharmacist Cardio-thoracic Surgery

ERIK ABEL, PHARM D

Page 30: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Page 31: An Evening with your Pharmacists MENDED HEARTS.  Specialty Practice Pharmacist  Electrophysiology MIKE BOYD, PHARM D

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

Primary Care Physician, Cardiologist Pharmacist Dentist

HOW CAN I HELP MYSELF