|The Consultant Pharmacist|
IN THIS ISSUE
August 2018 | Volume 33 | Number 8
Many problems can be avoided with good communication among providers, patients, and family caregivers.
Pharmacists Focus on Adapting for the Future A wide range of changes are in the future for health care: valuebased reimbursement, delivery of integrated services, the continued breakdown of silos, and interoperability that can maximize communication/information exchange. The American Society of Consultant Pharmacists recently held a conference focusing on key innovations in post-acute/long-term/senior care and how pharmacists can function successfully in this new paradigm in ways that promote quality medication management, address polypharmacy, improve patients’ quality of life, reduce costs, and eliminate avoidable readmissions.
Ophthalmic medication therapy retards the progression of glaucoma, but many older patients require multiple medications to preserve vision and quality of life. An agent from the ophthalmic prostaglandin analog class is used as initial therapy in current practice because of the convenience of once-a-day administration and lower incidence of systemic side effects and slightly increased efficacy compared with other ophthalmic medication classes. The other classes used in clinical practice include the beta-adrenergic blocking agents, the alpha-2 adrenergic agonists, and the carbonic anhydrase inhibitors.
This case report describes an 81-year-old female who developed hyponatremia/syndrome of inappropriate antidiuretic hormone (SIADH) after two doses of duloxetine. Hyponatremia/SIADH develops rapidly after initiation of duloxetine. Clinicians should be aware of the potential for this adverse drug reaction, particularly in elderly females. This case is consistent with literature reports of elderly females who developed hyponatremia/SIADH within days of being initiated on duloxetine.
Cranberry supplementation is an attractive option for preventative urinary tract infections (UTIs) therapy that does not lead to microbial resistance. However, the efficacy of cranberry is controversial in current literature for the prevention of UTIs in older adults owing to the diversity of the older population as well as inconsistencies in the dose of proanthrocyanidins used in each study. Despite the conflicting data, when studied in specific populations, it appears that prophylactic cranberry products have a beneficial effect on the incidence of UTI while providing a safe alternative to antibiotics.
This study found that medication errors, adverse drug events (ADEs), and potential ADEs are common in patients 65 years of age or older taking more than three medications. Almost half of the detected ADEs in the ambulatory care center where this study was conducted were preventable. Five medications found to be commonly involved with adverse drug reactions were: antibiotics, cardiovascular agents, anticonvulsants, psychotropics, and theophylline. Though not originally considered in this study’s scope, it became very evident that the interventions of a clinical pharmacist would help decrease such events.
This will be a year of upheaval for nursing facilities, but opportunities for pharmacies and pharmacists continue to proliferate.
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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.
2018 ASCP Integrated Media Kit
Nonmembers can access online abstracts to journal articles. Full articles are available for $35.00 each.
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