November 23, 2022
Managing drug therapy in terminally ill COPD patients can certainly be challenging. Patients may be resistant to changing long-term medication regimens.1 Patients and caregivers may even interpret medication adjustments as giving up, patient abandonment, or as a suggestion that death is imminent.1 In this patient population, especially, some medications that were once effective may no […]
Read MoreNovember 10, 2022
About 6.5 million Americans over 65 have Alzheimer disease and that number’s expected to balloon to 14 million by 2060.1 Many transition to hospice services, so hospice clinicians are sure to encounter patients taking the latest branded medications. One is a drug approved by the U.S. Food and Drug Administration (FDA) in March 2022 called […]
Read MoreSeptember 13, 2022
With seemingly innumerable generic variants among dosage forms, diltiazem undoubtedly causes more confusion than any other drug when it comes to generic substitutions. As of August 2022, the FDA Orange Book lists a whopping 117 active diltiazem formulation/strength/manufacturer combinations. So, how do prescribers and pharmacists sort this mess out? Among those 117 products are “injectable”, […]
Read MoreAugust 2, 2022
Albuterol and levalbuterol are short-acting beta-2 agonists (SABAs) that are used to manage acute breathlessness associated with asthma, COPD, or bronchospasm.1-3 Both drugs exert their primary effects by binding to beta-2 receptors in the lungs, which causes smooth muscle relaxation and bronchodilation.1-3 So, what’s the difference between the two? Albuterol is a racemic mixture, meaning it contains […]
Read MoreJune 16, 2022
Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and inflammation.1,2With more than 20 different (but similarly effective) NSAIDs on the market, why would a provider prescribe or recommend one NSAID over another?3-5 Cox-Selectivity NSAIDs inhibit cyclooxygenase (COX) enzymes to prevent the production of prostaglandins, which are chemical mediators of pain and inflammation.1-6 There […]
Read MoreApril 20, 2022
Antiemetics like prochlorperazine, haloperidol, or ondansetron are often prescribed to alleviate nausea in hospice patients, but there are always situations where symptoms don’t respond, contraindications exist, or medications aren’t readily available. One outside-the-box remedy that hospice clinicians might consider adding to their nausea management toolbox is inhaled isopropyl alcohol vapor. Some compelling evidence for using […]
Read MoreApril 6, 2022
An Update from the American Gastroenterological Association Deprescribing (the planned process of reducing a medication’s dose or stopping it completely) is now a relatively well-known term among hospice clinicians.1 Clear deprescribing guidance is lacking for many drugs, but this isn’t the case for proton pump inhibitors (PPIs). In addition to robust resources from Deprescribing.org and […]
Read MoreJanuary 27, 2022
Lately, it seems like new developments concerning the COVID-19 pandemic have been flying around at a head-spinning pace. You’ve probably been bombarded with news of a highly contagious variant, sky-rocketing case numbers, or constantly evolving clinical guidance. One of the more encouraging developments is that oral antiviral drugs for COVID-19 have finally arrived. In late […]
Read MoreJanuary 13, 2022
As a pediatric neurology pharmacist, my role is to ensure safe and accurate use of medications. For patients with seizures, this includes addition of a rescue medication for prevention of status epilepticus (SE). Despite the fact that intranasal midazolam is evidence-based, inexpensive, accessible, and well-tolerated, it’s an underutilized option in all clinical settings, including hospice […]
Read MoreDecember 28, 2021
Just like Oscar the cat can identify and comfort patients who are near death, it seems that another unusual suspect has a keen sense for helping humans who are approaching the end of life. Peyo (affectionately nicknamed “Dr. Peyo”) is a 15-year-old former show stallion that literally roams the halls of the palliative care center […]
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