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Albuterol vs. Levalbuterol: What’s the Difference?

Albuterol and levalbuterol are short-acting beta-2 agonists (SABAs) that are used to manage acute breathlessness associated with asthma, COPD, or bronchospasm.1-3 Both drugs exert their primary effects by binding to beta-2 receptors in the lungs, which causes smooth muscle relaxation and bronchodilation.1-3 So, what’s the difference between the two?

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Factors that influence NSAID selection

Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat pain and inflammation.1,2­ With more than 20 different (but similarly effective) NSAIDs on the market, why would a provider prescribe or recommend one NSAID over another?3-5

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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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Charlie Otterbeck

OnePoint Patient Care

P 847-583-5652

cotterbeck@oppc.com

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