Clinicians in rural care require knowledge and skills in clinical pharmacology and a clinical pharmacology-based approach could individualize pharmacotherapies. Atrial fibrillation and heart failure are very common disease states for rural care clinicians. Appropriate beta-blocker agent selection for heart failure management attributes to clinical pharmacology. Also, optimal diuretic dose management is based on the ceiling dose theory. The appropriate direct oral anticoagulant agent selection for patients with atrial fibrillation is also mainly based on each agent's pharmacological characteristics.
This presentation will focus on three major clinical pearls that clinicians in rural care could apply to their routine patient care: 
1. Beta-blocker optimization for patients with heart failure based on patients' comorbidities (uncontrolled asthma, uncontrolled hypertension, or esophageal varices) 
2. Optimizing a diuretic dose in patients with heart failure based on the ceiling dose concept
3. Selecting an appropriate direct oral anticoagulant based on clinical pharmacological properties and patients' comorbidities (e.g., kidney/liver function)