JAAPA CME Post-Test January 2019

No Longer Failing to Treat Heart Failure: A Guideline Update Review
Heart failure is a leading cause of hospital admissions and death in the United States and worldwide. In 2016, the American Heart Association, the American College of Cardiology, and the Heart Failure Society of America released a joint focused guideline update for the management of patients with Stage C heart failure with reduced ejection fraction. An additional update released in 2017 reinforces the 2016 update’s strong recommendation for substituting angiotensinconverting enzyme inhibitors or angiotensin receptor blockers with an angiotensin receptor-neprilysin inhibitor to reduce morbidity and mortality in selected patients. The 2017 and 2016 updates also support adding a sinoatrial node modulator to further reduce heart rates in patients already maximized on beta-blocker therapy. These innovative therapies can significantly improve patients’ quality of life and reduce the healthcare costs associated with managing heart failure.

Education Objectives

  • Describe the changes made to the 2013 ACCF/AHA heart failure guidelines with the 2016 and 2017 updates.
  • Explain the benefits of non-pharmacologic therapy for heart failure.
  • Compare and contrast the use of ACE inhibitors or ARBs with an angiotensin receptor neprilysin inhibitor and the use of beta-blockers with ivabradine.

Trigger Finger: An Overview of the Treatment Options
Stenosing flexor tenosynovitis, more commonly known as trigger finger, is one of the most common causes of hand pain and dysfunction. Clinicians must be able to identify the disorder, know the broad range of treatment options, and counsel patients on the treatment best suited for their condition. Awareness of the economic burden each option entails is central to optimizing treatment outcomes and patient satisfaction. This activity outlines the presentation and treatment of trigger finger.

Education Objectives
  • Describe the typical presentation of a patient with trigger finger.
  • List the commonly used treatments to manage symptoms of trigger finger.
  • Describe the economic effect of the various treatment options with regards to therapeutic decision-making.

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