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Hydroxyzine is a first generation histamine (H₁) antagonist that’s been on the market since the 1950’s.¹ Its mechanisms of action are unique. Not only does it compete with histamine for H₁ receptor sites in the GI tract, blood vessels, and respiratory tract, but it also it exhibits activity at muscarinic, serotonergic, and dopaminergic receptors in various parts of the brain, which may explain its anxiolytic effect.² Hydroxyzine is available in two different salt forms, hydroxyzine hydrochloride (HCl) (commonly known as Atarax) and hydroxyzine pamoate (commonly known as Vistaril).

Our “Together as One” series spotlights 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 with innovative and responsive hospice partners, they create the network of support so essential to hospice care. We invite you to meet the people behind the mission—and see what one can do.

Nickyia Harper, MS HRMD

Supervisor, Connect+ HUB Services

Morton Grove, IL

How did you become interested in pharmacy?

My passion to help others and desire to become a pharmacist during my childhood, along with having the opportunity to work in a hospital throughout my high school years, all played a huge role in me becoming interested in healthcare and pharmacy.

What are your favorite aspects of your job?

With my educational background being in Human Resources,...

Most of us don’t think twice about where we keep our cell phones as we go about our daily business. However, for people with implanted cardiac devices, storing the phone in a shirt or jacket pocket near the chest could have serious unintended consequences.

A Quick Overview of the Causes of Urinary Discoloration

Terminally ill patients may experience a variety of changes and new symptoms as the end of life approaches. Urinary symptoms may be especially troublesome for patients, family members, caregivers, and clinicians. Hospice patients commonly experience incontinence, retention, and decreased output. Another distressing change that patients may experience is abnormal urine color.

Being a prognosticator, or a predictor, is one of many hats that hospice clinicians wear. The ability to provide an accurate prognosis plays a crucial role in many clinical decisions. In addition to clinical experience, hospice clinicians use tools like the Palliative Performance Scale (PPS) to help predict survival. Believe it or not, there’s one very unconventional prognosticator that’s seemingly able to predict a patient’s imminent death with amazing accuracy - a cat named Oscar.

Pseudobulbar affect (PBA), also called emotional lability, is a condition of uncontrollable laughing or crying without provocation that isn’t consistent with a patient’s emotional state. PBA is most often observed in patients with neurological disorders such as amyotrophic lateral sclerosis (ALS), multiple sclerosis, Parkinson’s disease, Alzheimer’s disease, brain tumors, or as a sequela of stroke. The management of this condition includes an FDA-approved drug combo of dextromethorphan and quinidine, or Nuedexta®, which has also been used off-label for controlling agitation or aggression in Alzheimer’s dementia patients. Nuedexta® comes with a hefty price tag (AWP is $26.70 per dose) and is only available as an oral capsule, presenting potential barriers to use in hospice given capitated reimbursement rates and drug administration challenges in patients with dysphagia.

Since treatment with Nuedexta® may be cost-prohibitive and dextromethorphan (DM) is readily available as an...

Our “Together as One” series spotlights 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 with innovative and responsive hospice partners, they create the network of support so essential to hospice care. We invite you to meet the people behind the mission—and see what one can do.

Achille Tiam, PharmD

Pharmacist

Las Vegas, NV

How did you become interested in pharmacy?

My interest in pharmacy came from several conversations with my brother, who is also my mentor and a pharmacist. Before going into pharmacy, I was a teacher and kept bragging to my brother that I am a key element in society because I have an impact in each of my student’s lives. In response to my self-important speech, my brother stated that he has the opportunity to not only...

Our “Together as One” series spotlights 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 with innovative and responsive hospice partners, they create the network of support so essential to hospice care. We invite you to meet the people behind the mission—and see what one can do.

Ryan Volkman

Service Delivery Director

Tempe, AZ

What is your role with OnePoint Patient Care?

I've been with OnePoint for the past 14 years, and am currently the Service Delivery Director to Arizona hospices.

What inspired you to pursue a career in Health-Care?

My first exposure to the health care field was from my mom working as a Respiratory Therapist for home care and in the hospital. 

Neuropathic pain is pain caused by a lesion or disease of the somatosensory system¹ and is often described as sensations of burning, tingling, shooting, sharpness, stabbing, or like electrical shocks. It is associated with conditions seen in many hospice patients including cancer, diabetes, and stroke. Neuropathic pain may also be a complication of neuromuscular diseases (like ALS or multiple sclerosis) or nerve injury that may occur following trauma, surgery, or infection (e.g. shingles). Sometimes the cause may be unknown, but what’s clear is that neuropathic pain can be a significant source of discomfort and debility.

When patients transition to hospice, deprescribing can be used as a tool to align treatment plans with changing goals of care. Deprescribing is the process of discontinuing inappropriate, ineffective, or unnecessary medications and is often used in an attempt to manage polypharmacy and improve patient outcomes.¹ Medications used to treat hypertension (collectively referred to as antihypertensives) should be among those medications considered for deprescribing if they’re ineffective for palliating symptoms or improving quality of life, especially in older patients who are often more susceptible to medication adverse effects (including dizziness and hypotension leading to falls).