The Consultant Pharmacist


March 2017 | Volume 32 | Number 3

Advancing Our Decision Making

Editor-in-Chief, H. Edward Davidson, PharmD, MPH, gives a brief commentary on this issue of the journal and current new items of interest to consultant pharmacists.

Antibiotic Stewardship: New Frontier, Familiar Journey

Recent changes in regulations by the Centers for Medicare & Medicaid Services require long-term care facilities to meet specific requirements on antibiotic stewardship, promoting the appropriate use of antibiotics and antimicrobials. The goal is to decrease the spread of infections caused by multi-drug-resistant organisms. Consultant pharmacists can help facilities implement policies and procedures for effective antibiotic stewardship, assist prescribers and facility staff, find appropriate resources, and provide facility personnel with feedback on their stewardship efforts.

Chad Worz: The Antipharmacist

Chad Worz, PharmD, is president and founder of Medication Managers, LLC, a consulting practice that serves nursing facilities and long-term care pharmacy clients across the country.

Retained Skeletal Effects of Zoledronic Acid Following Discontinuation of Treatment: A Review of the Literature

A single zoledronic acid infusion has been shown to decrease bone turnover markers and improve bone mineral density for at least 12 months after infusion. Patients may experience continued benefit beyond this period, but there is concern that this long-term effect may lead to severe bone-turnover suppression, increased bone fragility, and increased risk of fractures. Additional studies should be conducted to determine the long-term effects of discontinuing zoledronic acid therapy on bone health.

A Review of Suvorexant, Doxepin, Ramelteon, and Tasimelteon for the Treatment of Insomnia in Geriatric Patients

Older individuals experience insomnia with a high prevalence. Current therapy with benzodiazepines, nonbenzodiazepine hypnotics, and antihistamines are associated with rebound insomnia, withdrawal, and tolerance, and put elderly patients at increased risk for cognitive decline, falls, and fractures. It is crucial that alternative therapies are attempted in this patient population.

Pharmacist Counseling and the Use of Nonsteroidal Anti-Inflammatory Drugs by Older Adults

NSAID use by older adults continues to be an issue in the health care community. Patients who are counseled on appropriate NSAID use are more likely to use NSAID therapy appropriately. NSAID use can be improved through pharmacist intervention and counseling when inappropriate use is identified. In this study, following counseling on NSAIDs, the number of inappropriate users decreased by 48.7%.

Use of an Ambulatory Prescribing Guidance Tool to Improve Patient Safety in the Geriatric Population

This study evaluated the effectiveness of a clinical decision support tool to decrease the prescribing of glyburide in the ambulatory setting of an academic medical center. The overall prescribing rate of glyburide in elderly patients was significantly lower in the months following implementation of the tool.

Congress Continues to Focus on Drug Pricing

An update on health care policy from ASCP's director of policy and advocacy.


The Consultant Pharmacist® is the official monthly peer-reviewed journal of the American Society of Consultant Pharmacists (ASCP). It is the only journal dedicated exclusively to the medication therapy needs of seniors. ASCP members receive The Consultant Pharmacist® as a member benefit. All articles (2004 to present) are free online for members.

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H. Edward Davidson, PharmD, MPH
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