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News+Views: Rectal Administration of Anticonvulsants

There is a need for alternative routes of administration in hospice and palliative care patients who often suffer from nausea and vomiting, dysphagia, gastrointestinal obstruction, and mental status changes, all of which may limit intake of oral medications.  Compared to common alternative routes such as the intravenous and intramuscular routes, the rectal route of administration has certain practical advantages, as it does not require extensive patient or caregiver education and can be administered in the comfort of one’s own home. In addition, it is generally less expensive when compared to topical, subcutaneous, or intravenous routes.1

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Together as One | Pharmacist Profile: Gary Henglefelt, BSPS

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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.

Gary Henglefelt, BSPS

Vice President of Pharmacy Operations - Western Division

Tempe, AZ

 

How did you become interested in pharmacy?

Growing up on a farm in South Dakota provided a working relationship with the local pharmacy. Mostly for vet medications but it developed my interest as to the knowledge of a pharmacist and what help they provide.

What are your favorite aspects of your job?

Helping nurses and caregivers provide needed care to patients at the end of...

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Together as One | Pharmacist Profile: Shekar Ganesh, PharmD

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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.

Shekar Ganesh, PharmD

Pharmacist and Assistant Manager

Morton Grove, IL

 

How did you become interested in pharmacy?

I enjoyed working as an inpatient hospital pharmacy technician prior to pharmacy school, which further sparked my curiosity in a career in pharmacy. Additionally, I enjoyed learning general chemistry and organic chemistry, both of which are important to understanding pharmacology.

What are your favorite aspects of your

 job?

I feel great that I can...

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Together as One | Pharmacist Profile: Kirk Davis, PharmD

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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.

Kirk Davis, PharmD

Pharmacist-in-Charge

Vancouver, WA

 

How did you become interested in pharmacy?

I originally graduated in December 2008 with a BA in Economics. This was at the height of the Great Recession, limiting entry level career opportunities and causing me to reflect on the possibility of returning to school. I ultimately decided to pursue a doctor of pharmacy degree because the pharmacy field seemed stable and offered me a chance to study the hard...

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Our partners can rest assured: you’re in full compliance with Medicare Part D

Red Ring Binder with Inscription Compliance on Background of Working Table with Office Supplies, Laptop, Reports. Toned Illustration. Business Concept on Blurred Background.

Have you read the report from the Department of Health and Human Services? Medicare Part D reimbursements for hospices are likely to be scrutinized more carefully in the near future.

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1 Minute Consultation: "Which Potassium Supplement Should I Order for a Patient With Dysphagia?"

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Diuretics can be especially useful to the hospice clinician for managing fluid retention or edema that commonly occurs in patients with heart failure, cirrhosis, and cancer. Unfortunately, long-term use of loop and thiazide diuretics can lead to hypokalemia, which can be particularly challenging to treat in patients with dysphagia given the fact that many potassium chloride (KCl) supplements are inherently large and difficult to swallow. It’s important to consider the potential alternatives for patients with dysphagia and the advantages and disadvantages of the various KCl formulations that are currently available: tablets, capsules, powder for solution, and oral solution (Table 1). When choosing a KCl product, the hospice team should consider special instructions for administration, palatability, risk for adverse effects, and contraindications of each.

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Questions from readers: Is one probiotic better than another?

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With so many different probiotics on the market, it’s hard to know which ones to use and when to use them. They’re commonly promoted as agents to help strengthen the immune system or recolonize the GI tract with “good bacteria." Probiotics are found in foods, dietary supplements, infant formulas, and medical foods with strain compositions, doses, and storage requirements that vary widely among products. Since the evidence for various indications is formula-specific (genus, species, strain, number of live bacteria present, blend of probiotic strains, non-active ingredients) and the commercial availability is constantly changing it can be challenging to be sure you’re choosing the right probiotic for your patients, especially in a field that’s still evolving.

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Together As One | Nurse Profile: Pam

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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.

Pam Clemit, RN, Case Manager

Sage Hospice and Palliative Care

Scottsdale, AZ

 

What inspired you to become a nurse?

My mom. As long as I could remember, my mom was a nurse. She was able to care for her family full time when we were young and went to work part time when we got older. She always loved her work and was able to balance her work and her family.  I always felt like I wanted to care for people. In my youth, I would visit my elderly grandparents. It was...

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In the News: Hospice and Palliative Care Consensus Group Issues Methadone Safety Guidelines

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In 2014, the American Pain Society (APS), College on Problems of Drug Dependence, and the Heart Rhythm Society released clinical practice guidelines that focused primarily on safe methadone prescribing practices.

The APS guidelines included information regarding patient education, dosing and titration methods, recommendations for electrocardiograph (ECG) and adverse event monitoring. Unfortunately, these guidelines didn’t account for patients with limited life expectancies. Since there is less utility in aggressively monitoring this patient demographic, in 2015, a panel of 15 hospice and palliative care (HPC) experts convened to develop their own guidelines on methadone treatment for patients with life-limiting illnesses. Following a systematic search and review of methadone literature, along with evaluating the APS guidelines, their guidance aimed to maximize benefits and minimize risks for these patients. Their opinions, “Safe and Appropriate Use of Methadone in Hospice and...

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Together as One | Nurse Profile: Brandi

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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.

Brandi Wethington, BSN, RN

Treasure Health

Fort Pierce, FL

 

What inspired you to become a nurse?

From the time I was a little girl, I always wanted to be a nurse. I aspired to advocate for patients, to empower people to make informed decisions, to be a comfort to people during a difficult time and to be someone who was trusted to always do the right thing.

How did you come to work in hospice specifically?

My grandmother was in hospice care for the last couple...

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Media Contact

Charlie Otterbeck

OnePoint Patient Care

P 847-583-5652

cotterbeck@oppc.com

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