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Inhaled Isopropyl Alcohol for Nausea

Antiemetics like prochlorperazine, haloperidol, or ondansetron are often prescribed to alleviate nausea in hospice patients, but there are always situations where symptoms don’t respond, contraindications exist, or medications aren’t readily available. One outside-the-box remedy that hospice clinicians might consider adding to their nausea management toolbox is inhaled isopropyl alcohol vapor.

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Deprescribing Proton Pump Inhibitors

An Update from the American Gastroenterological Association

Deprescribing (the planned process of reducing a medication’s dose or stopping it completely) is now a relatively well-known term among hospice clinicians.1 Clear deprescribing guidance is lacking for many drugs, but this isn’t the case for proton pump inhibitors (PPIs). In addition to robust resources from Deprescribing.org and Primary Health Tasmania, the American Gastroenterological Association (AGA) recently published their deprescribing advice for PPIs.

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Together as One | Iris Jiao

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.

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Together as One | Lisa Sandoval

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.

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In the News: New Oral Antiviral Drugs Added to the Armamentarium Against COVID-19

Lately, it seems like new developments concerning the COVID-19 pandemic have been flying around at a head-spinning pace. You’ve probably been bombarded with news of a highly contagious variant, sky-rocketing case numbers, or constantly evolving clinical guidance. One of the more encouraging developments is that oral antiviral drugs for COVID-19 have finally arrived. In late December 2021, the U.S. Food and Drug Administration (FDA) first granted Emergency Use Authorization (EUA) for Pfizer’s Paxlovid (nirmatrelvir/ritonavir) and then for Merck and Ridgeback Biotherapeutics’ molnupiravir, giving the drug makers the green light to begin distributing their products in the United States.1,2 While other COVID-19 treatment options exist, oral antiviral drugs are being touted as potential game changers since they can be used in the outpatient setting to keep patients out of the hospital (freeing up resources for sicker patients) and prevent death.3

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Treating impending status epilepticus with intranasal midazolam

As a pediatric neurology pharmacist, my role is to ensure safe and accurate use of medications. For patients with seizures, this includes addition of a rescue medication for prevention of status epilepticus (SE). Despite the fact that intranasal midazolam is evidence-based, inexpensive, accessible, and well-tolerated, it’s an underutilized option in all clinical settings, including hospice and palliative care.

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Oscar the Cat, Meet Dr. Peyo the Horse

Just like Oscar the cat can identify and comfort patients who are near death, it seems that another unusual suspect has a keen sense for helping humans who are approaching the end of life. Peyo (affectionately nicknamed “Dr. Peyo”) is a 15-year-old former show stallion that literally roams the halls of the palliative care center of Calais Hospital in northern France. His trainer, Hassen Bouchakour, could tell early on that he was special. According to Bouchakour, Peyo is not usually an attention seeker, but always seemed to approach those who were likely emotionally, physically, or psychologically vulnerable and would act in an especially gentle and protective manner.

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In The News: Are Barnacles the Answer for Bleeding Humans?

Thankfully, most hospice patients will never experience significant bleeding. That said, when it does occur in can be extremely traumatic. Patients with end-stage renal or liver disease, cancer (especially head/neck and large lung tumors), and those receiving anticoagulation are at higher risk for serious bleeding. OnePoint's Clinical Symptom Guide, now in its 3 rd edition, details numerous drug therapy options for treating bleeding, and in the future, we may be adding another option with quite an unusual and interesting backstory behind its development.

It’s inherently difficult to create a seal on bleeding tissue, since it’s a wet environment and blood is a liquid made up of many different cells – the blood (and cells) needs to be moved out of the area for a tight seal to be made. To combat this issue, clever researchers at the Massachusetts Institute of Technology (MIT) found inspiration in nature from a creature that has no problem with adhesion in a wet environments – barnacles.

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In the News: Aduhelm – A Breakthrough Drug or Break the Bank?

Earlier this year in June, the U.S. Food and Drug Administration (FDA) approved a new Alzheimer disease (AD) drug for the first time since 2003.1 Biogen’s Aduhelm (aducanumab) is a monoclonal antibody infusion that’s administered every 4 weeks and targets amyloid beta plaque aggregates in the brain – an underlying cause of AD.2,3 Aduhelm is currently labeled only for treatment of AD patients with mild cognitive impairment or mild dementia (the patient population studied in clinical trials).4 It’s not indicated for patients with more severe disease or other types of dementia since these patients weren’t studied and there’s no safety or efficacy data available.3,4

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NOACs, Insulins, and COPD Drugs in Hospice: Where Are We Now?

We hope you were able to join the March and April presentations from our 2021 clinical webinar series, Budget Busters – Best Practices with NOACs, Insulins, and COPD Drugs in Hospice. Throughout the webinar, our Senior Clinical Pharmacist, Melissa Corak presented pearls and practical strategies to promote cost avoidance in circumstances where hospices would otherwise be on the hook for paying for these often high cost medications. If you didn’t have the opportunity to tune-in (or want a refresher), the webinar can still be viewed on-demand on OneConnectPoint under the Clinical Resources tab.

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Charlie Otterbeck

OnePoint Patient Care

P 847-583-5652

cotterbeck@oppc.com

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