CBD in the Hospice Setting

More and more terminal patients and their families are calling upon cannabis to provide some symptom relief, and understandably so.  Cannabis has been used for centuries to treat a broad assortment of symptoms and diseases.  Over 100 known cannabinoids have been identified, each appearing to exert different effects.  Most Americans are fairly familiar with the…

Statin Discontinuation in Hospice Patients

  Hospice prescribers and pharmacists have long approached statins as appropriate for discontinuation in their patients who have no active cardiovascular disease since preventative or prophylaxis medications, as well as medications with long-term therapeutic outcomes, are not considered part of palliative care.  With the benefits of statin discontinuation ranging from decreasing pill burden to preventing…

Recent Generic Drug Approvals

Recent Generic Drug Approvals In the bustle of daily patient care, it is difficult to stay up-to-date on newly released generic medications, but doing so can prove beneficial.  In 2017, several medications potentially helpful in the hospice population became generic, including Seroquel XR®, Coreg CR®, and Pristiq®.  Though most generics available for these products are…

Opioids and Allergies

Hospice patients often communicate allergies to medications.  When the medication is an opioid, hospice staff often have to determine whether the reaction that the patient believed to be an allergy is truly an allergy and whether the reaction necessitates the avoidance of certain opioids.  True allergies involve an immune response; other reactions can fall into…

Increasing Awareness of Melatonin

The ever-increasing awareness of the dangers of hypnotic use in the elderly leaves many patients, prescribers, and caregivers hesitant to initiate prescription medications to treat insomnia.  Combined with the increased awareness and use of natural vitamins and supplements amongst hospice patients, many hospices are finding it desirable to utilize melatonin in certain patients having difficulty…

Make Sure the Pharmacist Knows…

Meeting the Conditions of Participations (CoPs) medication review requirements is important.  However, even more important is ensuring that the pharmacist performing the reviews is aware of all pertinent patient co-morbidities.  A complete list of co-morbidities is valuable in order to ensure that all potential disease-state/medication interactions are detected and the appropriate interventions are made.  Nursing…

Safe Medication Practices

The Institute for Safe Medication Practices (ISMP) has long recognized the frequency of mix-ups resulting from the non-standardization of units utilized in measuring volume of oral liquid medications.  Since 2009, ISMP has strongly encouraged all practitioners to solely utilize the metric system for measuring oral liquid doses. The National Council for Prescription Drug Programs (NCPDP)…

Options for Switching Antipsychotics

Medication cost, adverse effects, and poor therapeutic response often necessitate switching a hospice patient from one antipsychotic to another.  Prescribers can choose among several options when a switch is necessary. Abrupt switch: Often preferred by hospice prescribers, one antipsychotic can be abruptly discontinued with the immediate start of a new antipsychotic at a therapeutic dose.…