April 10, 2024
Occasionally, hospice clinicians may encounter patients with enteral feeding tubes (FTs). These tubes are used to provide enteral nutrition (EN) in individuals with a functioning GI tract who are otherwise unable to be fed orally.1 There are numerous types of tubes out there which are generally classified by insertion site and where in the body […]
Read MoreFebruary 6, 2024
If you’ve ever used software that checks for drug interactions, you’ve come across alerts regarding QT interval prolongation. But you work in hospice…are these still significant and what can you do about them? Let’s start with some basics1 -6: QT interval – a measure of ventricular repolarization in the heart QTc interval – QT interval […]
Read MoreDecember 21, 2023
A group home owner is requesting antibiotics for a hospice patient who’s been increasingly confused over the last several days and has foul smelling urine. You order a culture & sensitivity (C&S) that reveals bacterial growth in the urine and resistance to multiple antibiotics. The susceptible antibiotics listed on the report aren’t ideal because they […]
Read MoreSeptember 22, 2023
Earlier this year, the FDA expanded the list of approved indications for brexpiprazole (Rexulti®) to include the treatment of dementia-related agitation due to Alzheimer’s disease, making it the first antipsychotic (or any drug class for that matter) to gain FDA approval for treating agitation in patients with any type of dementia. Despite its new approval, […]
Read MoreAugust 1, 2023
Known for their role in managing diabetes, sodium-glucose cotransporter 2 (SGLT2) inhibitors like Farxiga (dapagliflozin) and Jardiance (empagliflozin) also improve symptoms, function, and quality of life in patients with heart failure (HF).1 So it’s no surprise that they were added to the latest HF guidelines, even for patients without diabetes.1 The 2022 American Heart Association […]
Read MoreJune 27, 2023
Loop diuretics are essential medications for managing fluid overload and edema caused by conditions like heart failure, liver disease, or chronic kidney disease.1-4 They work by decreasing renal sodium and chloride reabsorption with the end result being water excretion through urination (diuresis).1-3 You can learn more about loop diuretic pharmacology here. By far, furosemide is […]
Read MoreMay 23, 2023
Complementary and alternative medicines (CAM) are popular among patients because they’re readily available and perceived to be safe since they can be purchased over-the-counter without a prescription.1 While these products are relatively easy to obtain, they aren’t regulated like traditional medications. Importantly, CAM manufacturers aren’t generally required to demonstrate that products are safe or effective.1,2 […]
Read MoreApril 7, 2023
The oral route is by far the most common way medications are administered – even in the hospice setting. However, it’s not always feasible for a number of reasons – dysphagia, nausea/vomiting, or obtundation to name a few.1,2 Administering drugs subcutaneously (SC/SQ) is one method used to overcome patients’ inability to swallow and absorb oral […]
Read MoreMarch 24, 2023
Treating patients with severe dementia is complex and challenging. The frustrating reality is that these individuals are usually unable to communicate basic needs. In turn, unmet needs contribute to the behavioral and psychological symptoms of dementia (BPSD) — in particular, agitation, aggression (verbal and/or physical), apathy, and depression.1,2 BPSD are disruptive and distressing to the […]
Read MoreFebruary 22, 2023
One of the problems with starting traditional antidepressants in hospice patients is that they might take too long to start working (typically a few weeks) and/or reach their full effect (up to 8 weeks). To get around this, some hospice clinicians will prescribe methylphenidate or ketamine to treat depression more rapidly; the onsets are about […]
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