The Consultant Pharmacist


April 2018 | Volume 33 | Number 4

A Big Year for Innovation

After a decade of relatively slow progress in new drug development, 2017 was a banner year for approval of new molecular entities.

Safety Challenges with Insulin Delivery

The increase in accidental needle stick injuries are a growing concern. To access The Changing Impact of Sharps Injuries, Given a Growing Prevalence of People with Diabetes click here. To access Optimizing Insulin Delivery for Patients with Diabetes, click here.

2018 New Drug Update

Five new drugs marketed within the last year, which are used for medical problems often experienced by the elderly, have been selected for consideration in this review. The uses and most important properties of these agents are discussed, and a rating for each new drug is determined. Advantages, disadvantages, and other important information regarding each new drug are identified and used as the basis for determining the rating. The drugs include an anticoagulant, an antiparkinson agent, an agent for tardive dyskinesia, an agent for psoriasis, and an agent for constipation. The drugs reviewed are betrixaban, safinamide mesylate, valbenazine tosylate, guselkumab, and plecanatide.

VMAT2 Inhibitors: New Drugs for the Treatment of Tardive Dyskinesia

Tardive dyskinesia (TD) is largely iatrogenic. Valbenazine’s approval by the Food and Drug Administration was followed by the approval of deutetrabenazine, a drug with similar mechanism of action. Further data from postmarketing studies will be needed to verify that valbenazine’s adverse effect profile is different from the profiles of tetrabenazine and deutetrabenazine. Valbenazine and deutetrabenazine are available for those patients who may have tried a number of off-label therapies that failed to manage their TD symptoms.

Considerations for Geriatric Patients with Chronic Obstructive Pulmonary Disease

As patients age, they are predisposed to certain disease states such as chronic obstructive pulmonary disease (COPD). Physiologic changes that occur during aging as well as guidelines for treatment must be considered in providing pharmaceutical care for older adults. Preferred treatment options have special considerations in the aging population because of the inability to use certain inhaler devices and medications appropriately. This paper reviews physiologic changes in geriatric adults, COPD treatment, medications that should be avoided in this population, and special considerations for geriatric patients with COPD.

Use of Topical Morphine to Relieve Painful Pressure Ulcers

Palliative pharmacotherapy is focused on reducing the symptoms of disease while avoiding side effects that impair quality of life. Evidence suggests topical morphine can be an effective treatment option for painful pressure ulcers and can reduce the need for systemic opioids in select patients. In the palliative care setting, topical morphine may be considered for compassionate use when treatment with systemic analgesics is undesired, inadequate, or poorly tolerated. This alternative route of administration optimized the patient’s comfort while adhering to his wishes to remain alert and nonsedated by avoiding systemic opioids.

Pharmacist-Initiated Discharge Medication Reconciliation and Patient Counseling Procedures

A large part of transitional care is medication reconciliation, which is the process of creating the most accurate medication list as possible and capturing the changes in medications throughout the course of treatment. We found that pharmacists who completed discharge medication reconciliation identified errors in approximately 32% of medication lists per patient. On average, the study found that there were four discrepancies per patient (range 0 to 16); about 74% of patients had at least one discrepancy on their medication list. By identifying these discrepancies in the discharge medication process, pharmacists were able to decrease errors on medications after recommendations were made.

Adapting to a New Regulatory Environment

Accustomed to eight years of a heavy regulatory hand, we now find ourselves at the opposite extreme.


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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