September 10, 2024
As hospices operate with limited funds, minimizing drug costs is important. Therapeutic substitution, where one drug is replaced with a less expensive drug, is one tool to help with this. One substitution we’re occasionally asked about is using valproic acid (VPA) (Depakene) in place of divalproex sodium (Depakote). VPA costs about half as much as […]
Read MoreJuly 8, 2024
The oral route is by far the most popular and convenient means of drug administration, even in the hospice setting. However, for various reasons (e.g., dysphagia, nausea / vomiting, bowel obstruction, obtundation) as many as 70% of hospice patients will need their medications to be administered by non-oral routes.a-c Rectal drug administration is probably done […]
Read MoreMay 20, 2024
ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease, is an incurable progressive neurodegenerative disorder that leads to weakness, spasticity, and incoordination of the muscles involved in speaking, swallowing, breathing, and ambulation. Background1-4 Its onset most often occurs between the ages of 40 and 70, with a median survival time of 30 months, but […]
Read MoreApril 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 MoreMarch 12, 2024
Our “Together as One” series spotlights hospice programs, nurses, physicians, pharmacists and others who positively impact the lives of hospice patients and their families every day. Through the dedicated and compassionate work of these inspiring professionals, patients receive the high-quality care and attentive consideration they deserve. Together, they create the network of support so essential […]
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 MoreJanuary 26, 2024
Our “Together as One” series spotlights hospice programs, nurses, physicians, pharmacists and others who positively impact the lives of hospice patients and their families every day. Through the dedicated and compassionate work of these inspiring professionals, patients receive the high-quality care and attentive consideration they deserve. Together, they create the network of support so essential […]
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 […]
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