Medicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay

Size: px
Start display at page:

Download "Medicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay"

Transcription

1 Medicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay (Revised edition November 2015)

2 The Medicine Related Falls Risk Assessment tool (MrFRAT) in Appendix 1 is designed to help identify patients at risk of falls due to their current medicine regimen. The tool was developed using an evidence based assessment of the risk medicine classes have of causing falls. Instructions for use Who The Age Related Residential Care (ARRC) registered nurse is responsible for completing the Medicine Related Falls Risk Assessment Tool. A score 4 indicates that a medicine review may be beneficial to review those medicines which place the patient at a falls risk. The medicine review can be carried out by the resident s general practitioner or a clinical pharmacist facilitator working in the resident s general practice. When It is recommended that this tool is completed: a) As part of admission, during development of the long term care plan (first 3 weeks) b) As part of Post Falls Assessment It may also be of value to review: c) Annually as part of a multidisciplinary review d) Six monthly with care plan review e) As a communication tool with the general practitioner regarding specific medicines How For each regular medicine the resident is charted, decide if the medicine belongs to one of the following medicine classes: (for more information on medicines belonging to each class see Appendix 2). Hypnosedative (antipsychotics, benzodiazepine, zopiclone, sedating antihistamines) Antidepressant (all classes) Anticholinergic agent Antihypertensive (diuretics and alpha blockers only) Antiepileptic Digoxin

3 Medicines If the medicine belongs to one of the above classes, it is then assigned a score as indicated on the MrFRAT. Hypnosedatives and antidepressants are given a score of 2 per medicine, anticholinergic agents are given a score of 1 per medicine, and the other medicine classes have a score of 1 per classification (not medicine). Score each medicine only once; even it is part of two classes of medicine. If a medicine can be categorised within two medicine classes, use the highest score. An example is clonazepam which is a benzodiazepine prescribed for the management of epilepsy. Clonazepam is given a score of 2 as a hypnosedative, rather than a score of 1 as an antiepileptic agent. Only medicines prescribed on the regular medicine chart should be counted when completing the MrFRAT. As required medicines should not be included; however if a medicine is charted PRN but administered daily, then it should be included in the MrFRAT calculation, and the use of this medicine discussed with the general practitioner regarding it being charted as a daily medicine, or daily administration ceasing. Appendix 2 provides a list of common medicines for each medicine classes within the Medicine Related Falls Risk Assessment Tool. Long term medicines Next, count up the total number of medicines that are charted regularly; six or more daily regular orally administered medicines trigger a score of 2. Only orally administered medicines contribute to this score; the following are not included: Inhalers or nebulisers Topical creams or ointments Injections Eye and ear drops Nasal drops and sprays Exception Daily insulin does contribute towards the count for long term medicines due to the risk of hypoglycaemia and it therefore included in the count for 6 or more long term medicines. NOTE: Some preparations contain more than one medicine. Examples include: cilazapril + hydrochlorothiazide tablets docusate sodium + sennoside B tablets (Laxsol) paracetamol + codeine tablets When adding up the total number of oral daily medicines a resident is taking these combined products should be given a count of 1 for each medicine ingredient; therefore cilazapril + hydrochlorothiazide tablets count as 2 long term medicines even though it is administered as one tablet.

4 Only daily long term medicines contribute to this score; the following do not: monthly cholecalciferol (vitamin D) weekly folic acid weekly bisphosphonate, such as, alendronate or risedronate; or monthly etidronate The following supplements or complementary medicines should not contribute to this score. Examples: Cranberry capsules B complex tablets Multivitamins Kiwi crush Fish oil Magnesium Folic acid daily Exception: Daily St John s Wort supplement is counted as a long term oral medicine, due to the risk of interactions with other medicines and its action as an antidepressant. Gender If the resident is female this triggers a score of 1. Research has found a higher rate of falling and risk of fracture in females (>65 years) compare to males 1. Total up all the scores: medicine classes, number of medicines, and gender. 1 Chang V.C and Do M.T. Risk Factors for falls among seniors. Implications of Gender. Am J Epidemiol 2015; 181(7):

5 Example Patient AB, 86 years, female, prescribed the following: Quetiapine 25mg nocte Zopiclone 7.5mg nocte Inhibace Plus (cilazapril 5mg and hydrochlorothiazide 12.5mg) once daily Spironolactone 12.5mg once daily Citalopram 20mg daily Aspirin 100mg once daily Levetiracetam 500mg twice daily Symbicort Turbuhaler 200/6 Two puffs twice daily Cholecalciferol 1.25mg once a month Medicine Medicine Class Score Quetiapine 25mg nocte Antipsychotic hypnosedative 2 Zopiclone 7.5mg nocte Hypnosedative 2 Inhibace Plus Hydrochlorothiazide 12.5mg Cilazapril 5mg Antihypertensive diuretic Antihypertensive ACE inhibitor 1 No score for ACE inhibitor Spironolactone 12.5mg Antihypertensive 0 (antihypertensive category already counted ) Citalopram 20mg daily Antidepressant 2 Aspirin 100mg daily Antiplatelet 0 Levetiracetam 500mg bd Antiepileptic 1 6 medicines Quetiapine Zopiclone Cilazapril Hydrochlorothiazide Spironolactone Citalopram Aspirin Levetiracetam TOTAL = 8 Female 1 Total 11 2

6 Outcome based on risk score The action taken following the completion of MrFRAT is based on the risk score and/or whether the patient is currently taken vitamin D. Risk score 4 If the risk score is 4 the patient is considered at elevated risk of a fall due to the current medicine regimen. If the score is 4 a medicine review is recommended; please communicate to general practitioner as per the usual facility process. Risk score <4 but no vitamin D charted Complete vitamin D screening tool. Additional comments Space is provided on the MrFRAT sheet for the recording of additional comments. Information to be recorded here is anything that may be of assistance to the general practitioner or clinical pharmacist who is reviewing the medicines following a completed MrFRAT. Helpful information may include: Listing medicines not considered in MrFRAT but that may contribute to falls, such as opioids Listing other antihypertensive agents prescribed in addition to diuretics and/or alpha blockers If hypotensive If the resident has a prosthetic joint Medical conditions which may contribute to falls, for example rheumatoid arthritis, Parkinson s Disease Co-existing alcohol issues Recent cognitive decline

7 Additional resources RANZCP Practice Guideline: The Use of Antipsychotics in Residential Aged Care Royal Australian and New Zealand College of Psychiatrists URL: Helpful information within the above Guideline on: 1. Identifying the target problem/s: What is the aim of an intervention? 2. Formulating the target problem/s: Why is the challenging behaviour or symptom occurring? 3. Non-pharmacological management of the target problem/s: What interventions are worth trying Antipsychotics in dementia: Best Practice Guide URL: Helpful information includes: 1. Differential features of the 3Ds; Delirium; Depression and Dementia 2. Assessment of patients with BPSD a. Differential Diagnosis b. Contributing factors or triggers c. Identify problems d. Formulating the problem 3. Medicines that could precipitate or worsen BPSD 4. Factors that may contribute to or worsen BPSD Medicines Care Guides for Residential Aged Care Ministry of Health, New Zealand URL: Helpful information includes: Strategies to Reduce the Use of Antipsychotic Medicines Registered Nurse Care Guides for residential aged care Waitemata District Health Board URL: Helpful information on dementia, falls, syncope and collapse. Care giver guides available on Delirium, depression and dementia and Falls, fractures and incidents. Reducing Harm From Falls Programme Health Quality and Safety Commission URL:

8 Appendix 1: MrFRAT Template

9 Appendix 2: Common Medicines Listed below is a list of the common medicines contained within each medicine class; however, there may be others. Please refer to MIMS (New Ethicals) or New Zealand Formulary ( for a more comprehensive list. Hynosedatives Antihypertensives Antipsychotics Risperidone Quetiapine Olanzapine Aripiprazole Clozapine Prochlorperazine Benzodiazepines and Z-drugs Diazepam Clonazepam Lorazepam Oxazepam Nitrazepam Sedating Antihistamines Promethazine Cyclizine Antidepressants Fluoxetine Paroxetine Citalopram Escitalopram Sertraline Venlafaxine Mirtazapine Anticholinergics Oxybutynin Orphenadrine Solifenacin Diuretics Bendrofluazide Hydrochlorothiazide (Inhibace Plus, Accuretic and Losartan + hydrochlorothiazide) Indapamide Chlorthalidone Alpha Blockers Doxazosin Terazosin Anti-epileptics Phenytoin (Dilantin) Carbamazepine (Tegretol) Sodium Valproate (Epilim) Lamotrigine Haloperidol (Serenace, Haldol) Chlorpromazine (Largactil) Trifluoperazine (Stelazine) Levomepromazine (methotrimeprazine) (Nozinan) Ziprasidone Triazolam Temazepam Midazolam Zopiclone (a Z-drug) Clobazam Diphenhydramine Amitriptyline Nortriptyline Dothiepin Doxepin Imipramine Moclobemide Bupropion hydrochloride (Zyban) Benztropine Procyclidine Tolterodine Furosemide Bumetanide Spironolactone Prazosin Gabapentin (Nupentin) Levetiracetam Topiramate

10 Appendix 3: MrFRAT Fax Template (ISBAR format)

11 Acknowledgements The MrFRAT tool was developed by Clinical Pharmacists Peter McIntosh and Brendan Duck. The MrFRAT User Guide for ARRC staff and the General Practitioner Guide were developed by Clinical Pharmacist, Di Vicary. Together with the other members of the Hawke s Bay Clinical Pharmacist Facilitation team, the tool and guides were introduced across the region within primary care, increasing the focus on medicine related falls risk and individual patient medicine reviews. Additional acknowledgements: Health Hawke s Bay Hawke s Bay District Health Board All Age Related Residential Care facility clinical managers and nurses who participated in the training session related to the use of this tool and provided general feedback. Many thanks to all those involved with the development of these resources and their ongoing review. If you would like further information, please contact: Di Vicary Clinical Facilitator Medicines and Diagnostics (06)

Medicine Related Falls Risk Assessment Tool (MRFRAT)

Medicine Related Falls Risk Assessment Tool (MRFRAT) Medicine Related Falls Risk Assessment Tool (MRFRAT) The Medicine Related Falls Risk Assessment tool (MRFRAT) in Appendix 1 is designed to help identify patients at risk of falls due to their current medicine

More information

Medicines Formulary BNF Section 4 Central Nervous System

Medicines Formulary BNF Section 4 Central Nervous System Medicines BNF Section 4 4.1 Hypnotics and anxiolytics Chloral Hydrate 500mg/5ml Solution Clomethiazole 192mg Capsules Lormetazepam Tablets Melatonin Capsules Nitrazepam Suspension Nitrazepam Tablets Temazepam

More information

Pregnancy. General Principles of Prescribing in Pregnancy (The Maudsley, 12 th Edition)

Pregnancy. General Principles of Prescribing in Pregnancy (The Maudsley, 12 th Edition) Pregnancy General Principles of Prescribing in Pregnancy (The Maudsley, 12 th Edition) In all women of child bearing potential Always discuss the possibility of pregnancy; half of all pregnancies are unplanned

More information

South London and the Maudsley NHS Foundation Trust Medicines Formulary

South London and the Maudsley NHS Foundation Trust Medicines Formulary South London and the Maudsley NHS Foundation Trust Medicines Formulary Medicine Formulations Restrictions Additional Information / Related NICE Technology Appraisal 4.1 Hypnotics and anxiolytics 4.1.1

More information

Professor David Castle. Ms. Nga Tran. St. Vincent s Mental Health Level 2, 46 Nicholson Street, Fitzroy Vic 3065

Professor David Castle. Ms. Nga Tran. St. Vincent s Mental Health Level 2, 46 Nicholson Street, Fitzroy Vic 3065 ARABIIC Professor David Castle Ms. Nga Tran St. Vincent s Mental Health Level 2, 46 Nicholson Street, Fitzroy Vic 3065 (03) 9288 4147 (03) 9288 4751 Psychiatric Medication Information / Arabic 1 Psychiatric

More information

ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES MEDICATION FORMULARY

ALAMEDA COUNTY BEHAVIORAL HEALTH CARE SERVICES MEDICATION FORMULARY ANTIDEPRESSANTS Serotonin Selective Reuptake Inhibitors citalopram 10, 20, 40 mg, 10 mg/5cc $ 0.40 No escitalopram 10, 20 mg $ 2.60 Yes fluoxetine 10, 20 mg, 20 mg/5 ml $ 0.40 Yes fluvoxamine 25, 50, 100

More information

Chapter 4 ~ Central nervous system

Chapter 4 ~ Central nervous system Chapter 4 ~ Central Nervous System: General Section 1 of 6 Chapter 4 ~ Central nervous system 4.1 Hypnotics and anxiolytics 4.1.1 Hypnotics CHLORAL HYDRATE CLOMETHIAZOLE NITRAZEPAM TEMAZEPAM TRICLOFOS

More information

Palliative Care Drug Plan (Plan P) Formulary List of drugs PharmaCare covers

Palliative Care Drug Plan (Plan P) Formulary List of drugs PharmaCare covers Palliative Care Drug Plan (Plan P) Formulary List of drugs PharmaCare covers This formulary is current as of February 11, 2010. Important Notes: Pharmacists must submit a claim on PharmaNet at the time

More information

Safe transfer of prescribing guidance

Safe transfer of prescribing guidance Safe transfer of prescribing guidance TEWV Prescriber Summary Application required before prescribing Products requiring an application, before prescribing, using the single application form Unlicensed

More information

Calgary Long Term Care Formulary. Pharmacy & Therapeutics. February 2015

Calgary Long Term Care Formulary. Pharmacy & Therapeutics. February 2015 Calgary Long Term Care Formulary Pharmacy & Therapeutics February 2015 Highlights http://www.albertahealthservices.ca/4070.aspx 1 Contents February 2016... 3 Added Product(s)... 3 Not Listed, Delisted

More information

Alaska Medicaid 90 Day** Generic Prescription Medication List

Alaska Medicaid 90 Day** Generic Prescription Medication List 1 ACYCLOVIR 200 MG CAPSULE BUPROPION HCL 150 MG TAB ER 24H ACYCLOVIR 200 MG/5ML BUPROPION HCL 150 MG TABLET ER ACYCLOVIR 400 MG TABLET BUPROPION HCL 150 MG TABLET ER ACYCLOVIR 800 MG TABLET BUPROPION HCL

More information

Psychotropic Medication Use in Dementia

Psychotropic Medication Use in Dementia Psychotropic Medication Use in Dementia Marie A DeWitt, MD Diplomate of the American Board of Psychiatry and Neurology, Specialization in Psychiatry & Subspecialization in Geriatric Psychiatry Staff Physician,

More information

Medications and Children Disorders

Medications and Children Disorders Mental Health Comprehensive Services Providing Family Stability and Developing Life Coping Skills Medications and Children Disorders Psychiatric medications can be an effective part of the treatment for

More information

Katee Kindler, PharmD, BCACP

Katee Kindler, PharmD, BCACP Speaker Introduction Katee Kindler, PharmD, BCACP Current Practice: Clinical Pharmacy Specialist Ambulatory Care, St. Vincent Indianapolis Assistant Professor of Pharmacy Practice, Manchester University,

More information

Dr Hamish Jamieson. Geriatrician CDHB Senior Lecturer University of Otago, Christchurch

Dr Hamish Jamieson. Geriatrician CDHB Senior Lecturer University of Otago, Christchurch Dr Hamish Jamieson Geriatrician CDHB Senior Lecturer University of Otago, Christchurch 8:30-9:25 WS #144: Polypharmacy - Prescribing for the Elderly 9:35-10:30 WS #154: Polypharmacy - Prescribing for the

More information

Special Project. National Mental Health Benchmarking Project Forensic Forum. Seclusion Medication Audit

Special Project. National Mental Health Benchmarking Project Forensic Forum. Seclusion Medication Audit National Mental Health Benchmarking Project Forensic Forum Special Project Seclusion Medication Audit A joint Australian, State and Territory Government Initiative October 2007 National Benchmarking Project

More information

2017 Step Therapy Criteria

2017 Step Therapy Criteria FRESENIUS TOTAL HEALTH 2017 Step Therapy Updated 07/01/2017. For more recent information or other questions, please contact Fresenius Total Health Customer Service at 1-855-598-6774 / TTY 1-844-209-9094.

More information

PRESCRIBING PRACTICE IN DELIRIUM. John Warburton Critical Care Pharmacist

PRESCRIBING PRACTICE IN DELIRIUM. John Warburton Critical Care Pharmacist PRESCRIBING PRACTICE IN DELIRIUM John Warburton Critical Care Pharmacist Learning outcomes Modifiable medication risk factors for delirium An appreciation of contributing factors modifiable with medicines

More information

Study Guidelines for Quiz #1

Study Guidelines for Quiz #1 Annex to Section J Page 1 Study Guidelines for Quiz #1 Theory and Principles of Psychopharmacology, Classifications and Neurotransmitters, Anxiolytics/Antianxiety/Minor Tranquilizers, Stimulants, Nursing

More information

Use of Psychotropic Medications in Older Adults with Dementia!

Use of Psychotropic Medications in Older Adults with Dementia! Use of Psychotropic Medications in Older Adults with Dementia! Deepa Pattani, PharmD, RPh Owner: PrevInteract Health Deepa.Pattani@PrevInteract.com 972-372-9775 About Me Deepa Pattani, PharmD, RPh with

More information

Professionalism & Service with Great Prices

Professionalism & Service with Great Prices Acyclovir Capsules 200mg Viruses 30 90 Albuterol Syrup 2mg/5ml Asthma 120 360 Albuterol Sulfate Solution 0.05% * Asthma ----- ----- 20 60 Albuterol Sulfate Solution 0.083% Asthma ----- ----- 75 225 Alendronate

More information

Medication Reviews within Care Homes. Catherine Armstrong

Medication Reviews within Care Homes. Catherine Armstrong Medication Reviews within Care Homes Catherine Armstrong What is a Medication Review? A structured, critical examination of a patient s medicines with the objective of reaching an agreement with the patient

More information

Formulary for the JHM Outpatient Medication Assistance Program (OMAP)

Formulary for the JHM Outpatient Medication Assistance Program (OMAP) Note: The JHM Outpatient is a clinic-based program and may only be used by outpatient clinics and JHCP sites approved to participate in the program. To be eligible for OMAP, the patient must not have any

More information

NI Formulary: Chapter 4 Central Nervous system

NI Formulary: Chapter 4 Central Nervous system Hypnotics Anxiolytics Acute state Non drug treatment Temazepam tablets 10mg, 20mg; oral solution 10mg/5ml or Zolpidem tablets 5mg, 10mg or Zopiclone 3.75mg, 7.5mg Non drug treatment Diazepam tablets 2mg,

More information

Geriatric Pharmacology. Kwi Bulow, M.D. Clinical Professor of Medicine Director, Academic Geriatric Resource Center

Geriatric Pharmacology. Kwi Bulow, M.D. Clinical Professor of Medicine Director, Academic Geriatric Resource Center Geriatric Pharmacology Kwi Bulow, M.D. Clinical Professor of Medicine Director, Academic Geriatric Resource Center Silver Tsunami 2010: 40 million (13%) 2030: 72 million (20%) Baby Boomers (1946-1964)

More information

Step Therapy Medications

Step Therapy Medications Step Therapy Medications Step Therapy Group APTIOM Step-2: APTIOM 200 MG TABLET or APTIOM 400 MG TABLET or APTIOM 600 MG TABLET or APTIOM 800 MG TABLET Step 1 Drug(s): Oxcarbazepine immediate-release,

More information

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 759 M %

DT Description Price Category Price change Percentage BNF 1.2 Mebeverine 135mg tablets (100) 759 M % June 2016 On 13th May, the DH announced that there would be reductions to Category M prices from June until September. http://psnc.org.uk/our-news/contractor-notice-category-m-price-reduction/ This has

More information

Assessing the impact of medicine on falls risk

Assessing the impact of medicine on falls risk Medicines and falls Assessing the impact of medicine on falls risk This presentation is designed for registered nurses, but may be applicable to all nursing staff at the aged care facility. It is part

More information

Therapeutic options for adult patients unable to take solid oral dosage forms (Adapted from UKMi Q&A for use in Northern Ireland) Sep 2015

Therapeutic options for adult patients unable to take solid oral dosage forms (Adapted from UKMi Q&A for use in Northern Ireland) Sep 2015 Therapeutic options for adult patients unable to take solid oral dosage forms (Adapted from UKMi Q&A 294.3 for use in Northern Ireland) Sep 2015 BNF 1.3.5 Proton pump inhibitors Lansoprazole orodispersible

More information

A guide to reducing or stopping mental health medication. Notes for prescribers

A guide to reducing or stopping mental health medication. Notes for prescribers A guide to reducing or stopping mental health medication Notes for prescribers 1 Prescribers notes for reducing or stopping mental health medication These notes are written to augment the information for

More information

ANGIOTENSIN RECEPTOR BLOCKERS STEP THERAPY

ANGIOTENSIN RECEPTOR BLOCKERS STEP THERAPY South Country Health Alliance 2017 Step Therapy Formulary ID: 17431 Last Updated: 10/20/2017 Effective Date: 11-01-2017 ANGIOTENSIN RECEPTOR BLOCKERS STEP THERAPY BENICAR 20 MG BENICAR 40 MG BENICAR 5

More information

Introduction to Drug Treatment

Introduction to Drug Treatment Introduction to Drug Treatment LPT Gondar Mental Health Group www.le.ac.uk Introduction to Psychiatric Drugs Drugs and Neurotransmitters 5 Classes of Psychotropic medications Mechanism of action Clinical

More information

SMOKING AND DRUG INTERACTIONS

SMOKING AND DRUG INTERACTIONS Medicines Information Centre Pharmacy Department UK Medicines Information SMOKING AND DRUG INTERACTIONS Introduction Smoking rates are significantly higher among people with mental health problems. It

More information

Perinatal Mental Health: Prescribing Guidance for Trust Prescribers and GPs

Perinatal Mental Health: Prescribing Guidance for Trust Prescribers and GPs Perinatal Mental Health: Prescribing Guidance for Trust Prescribers and GPs (Version 3 January 2015) Principal Author: Dr Jenny Cooke Consultant Psychiatrist, Brighton & Hove Perinatal Mental Health Service

More information

STEP THERAPY PROGRAM

STEP THERAPY PROGRAM STEP THERAPY PROGRAM Step Therapy Program Certain prescription drugs call for a more detailed assessment to help ensure that they represent reasonable treatment. For these drugs, Great-West s Special Authorization

More information

Pharmacology in the Elderly

Pharmacology in the Elderly Pharmacology in the Elderly James Hardy Geriatrician, Royal North Shore Hospital A recent consultation Aspirin Clopidogrel Warfarin Coloxyl with senna Clearlax Methotrexate Paracetamol Pantoprazole Cholecalciferol

More information

Antipsychotics Detect, Select, Effect (P.I.E.C.E.S. 6 th Ed)

Antipsychotics Detect, Select, Effect (P.I.E.C.E.S. 6 th Ed) Antipsychotics Detect, Select, Effect (P.I.E.C.E.S. 6 th Ed) CLeAR Webinar February 14, 2014 Paula Diaz (Pharm) Carol Ward MD Carol Ward Tertiary Mental Health IHA Hillside Centre (Acute Tertiary Mental

More information

Prescribing Dilemmas. Sue Mulvenna Head of Pharmacy and CD Accountable Officer South Region SW 19 th May

Prescribing Dilemmas. Sue Mulvenna Head of Pharmacy and CD Accountable Officer South Region SW 19 th May Prescribing Dilemmas Sue Mulvenna Head of Pharmacy and CD Accountable Officer South Region SW 19 th May 2016 The four principles of medicines optimisation Aim to understand the patient s experience Evidence

More information

Drugs, Sleep & Wakefulness. Brian Koo Reena Mehra MD MS Kingman Strohl MD

Drugs, Sleep & Wakefulness. Brian Koo Reena Mehra MD MS Kingman Strohl MD Drugs, Sleep & Wakefulness Brian Koo Reena Mehra MD MS Kingman Strohl MD Things To Keep In Mind Many drugs effect sleep either causing insomnia or sedation Disruption of sleep and wakefulness may not be

More information

Riesbeck's Pharmacy Reward Club Generic Medication List February 2018 $4 30 Day Supply

Riesbeck's Pharmacy Reward Club Generic Medication List February 2018 $4 30 Day Supply Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml

More information

Stop smoking products guidance

Stop smoking products guidance Stop smoking products guidance Ref: Status: Approved Stop smoking products guidance Page 1 of 15 Approval date: 22 November 2018 Contents 1. Purpose... 3 2. Related documents... 3 3. Guidance... 3 3.1

More information

Management of Delirium in Hospice Patients

Management of Delirium in Hospice Patients Presentation Objectives Management of Delirium in Hospice Patients Lynn Williams, BSPharm Clinical Pharmacist Hospice Pharmacy Solutions Identify the clinical features of delirium Understand the underlying

More information

INTOXICATION DEATHS ASSOCIATED WITH DRUGS OF ABUSE OR ALCOHOL BALTIMORE CITY

INTOXICATION DEATHS ASSOCIATED WITH DRUGS OF ABUSE OR ALCOHOL BALTIMORE CITY 2009 FINAL REPORT INTOXICATION DEATHS ASSOCIATED WITH DRUGS OF ABUSE OR ALCOHOL BALTIMORE CITY This report was prepared by: Dr. Jose Arbelaez, M.D. of Baltimore Substance Abuse Systems, and Ryan J. Petteway,

More information

Chapter 4 ~ Central nervous system

Chapter 4 ~ Central nervous system Chapter 4 ~ Central Nervous System: Special Section 1 of 5 Chapter 4 ~ Central nervous system 4.1 Hypnotics and anxiolytics 4.1.1 Hypnotics LOPRAZOLAM Tablet 1mg LORMETAZEPAM Tablet 500microgram PROMETHAZINE

More information

AMANTADINE ER. Products Affected Step 2: OSMOLEX ER 129 MG TABLET, EXTENDED RELEASE OSMOLEX ER 193 MG TABLET, Details

AMANTADINE ER. Products Affected Step 2: OSMOLEX ER 129 MG TABLET, EXTENDED RELEASE OSMOLEX ER 193 MG TABLET, Details AMANTADINE ER OSMOLEX ER 129 MG, EXTENDED RELEASE OSMOLEX ER 193 MG, EXTENDED RELEASE OSMOLEX ER 258 MG, EXTENDED RELEASE PRIOR CLAIM FOR AMANTADINE HCL IMMEDIATE RELEASE WITHIN THE PAST 120 DAYS. 1 ANTICONVULSANTS

More information

M E D I C A T I O N S & Sean M. Jeffery

M E D I C A T I O N S & Sean M. Jeffery M E D I C A T I O N S & Sean M. Jeffery Subtitle Could my medications be causing me to fall? A discussion on medication safety and falls prevention. Contact Information & Disclosure Sean M. Jeffery, PharmD,

More information

AAA. add dan campbell artwork cats? Report #12 Changes in Medication Use over Time in Adolescents and Adults with Autism Spectrum Disorders

AAA. add dan campbell artwork cats? Report #12 Changes in Medication Use over Time in Adolescents and Adults with Autism Spectrum Disorders AAA Adolescents & Adults with Autism A Study of Family Caregiving add dan campbell artwork cats? Report #12 Changes in Medication Use over Time in Adolescents and Adults with Autism Spectrum Disorders

More information

Riesbeck's Pharmacy Reward Club Generic Medication List October 2017

Riesbeck's Pharmacy Reward Club Generic Medication List October 2017 Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Inj 50MG/ML 1 3 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml

More information

How to prescribe The elderly. Andi Shirtcliffe Pharmacist

How to prescribe The elderly. Andi Shirtcliffe Pharmacist How to prescribe The elderly Andi Shirtcliffe Pharmacist Psycho geriatric long stay hospital Rest home Generalist in a specialist setting Workshop outline Step through how I perform a medicine review Cases

More information

Care homes - Medication and falls

Care homes - Medication and falls Bulletin 87 December 2014 Community Interest Company Care homes - Medication and falls Falls and fall-related injuries are a common and serious problem for older people. People aged 65 and older have the

More information

Policy Evaluation: Low Dose Quetiapine Safety Edit

Policy Evaluation: Low Dose Quetiapine Safety Edit Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University 500 Summer Street NE, E35, Salem, Oregon 97301 1079 Phone 503 947 5220 Fax 503

More information

DEMENTIA AND MEDICATION

DEMENTIA AND MEDICATION DEMENTIA AND MEDICATION Dr. Siobhan Ni Bhriain, MRCP, MRCPsych. Clinical Director, Tallaght and SJH MHS, Consultant Old Age Psychiatrist, Chair, DSIDC Steering Committee. SUMMARY OF TODAY S TALK Dementia-definition,

More information

MEDICATION ALGORITHM FOR ANXIETY DISORDERS

MEDICATION ALGORITHM FOR ANXIETY DISORDERS Psychiatry and Addictions Case Conference UW Medicine Psychiatry and Behavioral Sciences MEDICATION ALGORITHM FOR ANXIETY DISORDERS RYAN KIMMEL, MD MEDICAL DIRECTOR HOSPITAL PSYCHIATRY UNIVERSITY OF WASHINGTON

More information

Riesbeck's Pharmacy Reward Club Generic Medication List September 2017

Riesbeck's Pharmacy Reward Club Generic Medication List September 2017 Drug Category Allergy, Cold & Flu Antibiotic Treatments Arthritis & Pain Riesbeck's Benzonatate 100mg cap 14 42 Diphenhydramine HCl Cap 50 MG 30 90 Diphenhydramine HCl Liquid 12.5 MG/5ML 720ml 2160ml Hydroxyzine

More information

Learning objectives: Become aware of a new treatment for bipolar disorder.

Learning objectives: Become aware of a new treatment for bipolar disorder. Learning objectives: Become aware of a new treatment for bipolar disorder. Identify possible mechanisms that could explain the efficacy of this treatment. Learn about the role of nutrient deficiency in

More information

Review of Psychotrophic Medications. (An approved North Carolina Division of Health Services Regulation Continuing Education Course)

Review of Psychotrophic Medications. (An approved North Carolina Division of Health Services Regulation Continuing Education Course) Review of Psychotrophic Medications (An approved North Carolina Division of Health Services Regulation Continuing Education Course) Common Psychiatric Disorders *Schizophrenia *Depression *Bipolar Disorder

More information

Antipsychotic Medications

Antipsychotic Medications TRAIL: Team Review of EVIDENCE REVIEW & RECOMMENDATIONS FOR LTC Behavioural and psychological symptoms of dementia (BPSD) refer to the non-cognitive symptoms of disturbed perception, thought content, mood

More information

ALLERGIC CONJUNCTIVITIS AGENTS

ALLERGIC CONJUNCTIVITIS AGENTS 2018 5 Tier Standard- Keystone First VIP Choice Document: 2018 Step Therapy Formulary ID: 18390 Last Updated: 04/2018 Effective Date: 05-01-2018 ALLERGIC CONJUNCTIVITIS AGENTS epinastine 0.05 % eye drops

More information

NorthSTAR. Pharmacy Manual

NorthSTAR. Pharmacy Manual NorthSTAR Pharmacy Manual Revised October, 2008 Table of I. Introduction II. III. IV. Antidepressants New Generation Antipsychotic Medications Mood Stabilizers V. ADHD Medications VI. Anxiolytics and Sedative-Hypnotics

More information

Falls most commonly seen in RACFs are due to tripping, slipping and stumbling (21.6%). Falling down stairs is relatively uncommon in

Falls most commonly seen in RACFs are due to tripping, slipping and stumbling (21.6%). Falling down stairs is relatively uncommon in This Presentation Medications and Falls Dr Peter Tenni M Pharm (Curtin), PhD (UTAS) AACPA Director, CPS A fall is an event which results in a person coming to rest inadvertently on the ground or floor

More information

Psychotropic Medications Archana Jhawar, PharmD, BCPP Clinical Faculty of UIC Pharmacy Practice Clinical Psychiatric Pharmacist Jesse Brown VA

Psychotropic Medications Archana Jhawar, PharmD, BCPP Clinical Faculty of UIC Pharmacy Practice Clinical Psychiatric Pharmacist Jesse Brown VA Psychotropic Medications Archana Jhawar, PharmD, BCPP Clinical Faculty of UIC Pharmacy Practice Clinical Psychiatric Pharmacist Jesse Brown VA Goals of Medications Use least number at lowest dose to get

More information

90-Day Generic Drug Discount List Treatment Medication Strength Dose Quantity Price Allergy/Cold&Flu Benzonatate 100mg Tablet 42 $15.

90-Day Generic Drug Discount List Treatment Medication Strength Dose Quantity Price Allergy/Cold&Flu Benzonatate 100mg Tablet 42 $15. 90-Day Generic Drug Discount List Treatment Medication Strength Dose Quantity Price Allergy/Cold&Flu Benzonatate 100mg Tablet 42 $15.00 Allergy/Cold&Flu C-Phen Drops n/a Drops 90 $15.00 Allergy/Cold&Flu

More information

The Basics of Psychoactive/Psychotropic Medications Tina Sanchez, RN, SMQT New Mexico Department of Health Division of Health Improvement State

The Basics of Psychoactive/Psychotropic Medications Tina Sanchez, RN, SMQT New Mexico Department of Health Division of Health Improvement State The Basics of Psychoactive/Psychotropic Medications Tina Sanchez, RN, SMQT New Mexico Department of Health Division of Health Improvement State RAI/MDS Coordinator Objectives Upon completion of this training,

More information

DT Description Price Category Price change

DT Description Price Category Price change Tariff T Watch October 2014 Readers are no doubt aware of this quarter's bad news for primary care prescribing allocations: NHS England has d the remuneration mechanism for community pharmacies gaining

More information

Medications for Anxiety & Behavior in Williams Syndrome. Disclosure of Potential Conflicts. None 9/22/2016. Evaluation

Medications for Anxiety & Behavior in Williams Syndrome. Disclosure of Potential Conflicts. None 9/22/2016. Evaluation Medications for Anxiety & Behavior in Williams Syndrome Christopher J. McDougle, M.D. Director, Lurie Center for Autism Professor of Psychiatry and Pediatrics Massachusetts General Hospital and MassGeneral

More information

Simply Step Therapy Document September 2018 Y0114_18_33074_I_009

Simply Step Therapy Document September 2018 Y0114_18_33074_I_009 2018 2018 Simply Step Therapy Document September 2018 Aptiom APTIOM 200 MG TABLET APTIOM 400 MG TABLET Y0114_18_33074_I_009 APTIOM 600 MG TABLET APTIOM 800 MG TABLET Criteria If the patient has tried a

More information

Therapeutic Drugs Monitoring TDM 2016 Therapeutic Drugs Monitoring Scheme Application Form

Therapeutic Drugs Monitoring TDM 2016 Therapeutic Drugs Monitoring Scheme Application Form complete all sections below and return to LGC Standards Proficiency Testing by email, fax or post. Returning customer Lab ID: TM Purchase order no.: (compulsory) TDM Distribution Schedule Samples for the

More information

Making Sense of the Long Term Care Mega Rule: Unnecessary Drugs & Psychotropics. Session Objectives. January 2018

Making Sense of the Long Term Care Mega Rule: Unnecessary Drugs & Psychotropics. Session Objectives. January 2018 Making Sense of the Long Term Care Mega Rule: Unnecessary Drugs & Psychotropics Bridget McCrate Protus, PharmD, MLIS, BCGP, CDP Director of Drug Information Optum Hospice Pharmacy Services Session Objectives

More information

INTOXICATION DEATHS ASSOCIATED WITH DRUGS OF ABUSE OR ALCOHOL BALTIMORE, MARYLAND QUARTERLY REPORT: FOURTH QUARTER, 2008 AND 2008 SUMMARY

INTOXICATION DEATHS ASSOCIATED WITH DRUGS OF ABUSE OR ALCOHOL BALTIMORE, MARYLAND QUARTERLY REPORT: FOURTH QUARTER, 2008 AND 2008 SUMMARY INTOXICATION DEATHS ASSOCIATED WITH DRUGS OF ABUSE OR ALCOHOL BALTIMORE, MARYLAND QUARTERLY REPORT: FOURTH QUARTER, 2008 AND 2008 SUMMARY A report from the Office of Epidemiology and Planning Baltimore

More information

BENZATROPINE (benz-a-tro-peen)

BENZATROPINE (benz-a-tro-peen) NEUROLOGICAL Medicines for parkinsonism and related disorders Anticholinergic medicines BENZATROPINE (benz-a-tro-peen) Common brands include: Benztrop, Cogentin Active ingredients (generic names) Other

More information

Have You Ever Wondered

Have You Ever Wondered Have You Ever Wondered A few facts about medication use and related falls The Number of Medications You Take & The Connection to Falls CONCERN: As you increase the number of medications that you take,

More information

Cash Wise Pharmacy $4 GENERIC MEDICATION FORMULARY. Cash Wise Pharmacy s $4 generic medication formulary is sorted by medical condition.

Cash Wise Pharmacy $4 GENERIC MEDICATION FORMULARY. Cash Wise Pharmacy s $4 generic medication formulary is sorted by medical condition. Cash Wise Pharmacy $4 GENERIC MEDICATION FORMULARY Cash Wise Pharmacy s $4 generic medication formulary is sorted by medical condition. 30- day 90- day 30- day 90- day quantity quantity quantity quantity

More information

3703 Camino del Rio South 100-A San Diego, CA, Phone Fax CLIA# 05D years

3703 Camino del Rio South 100-A San Diego, CA, Phone Fax CLIA# 05D years Drug Adherence Assessment Report CleanAssure TM (DRIED BLOOD SPOT): Detection Range see NOTES. Prescribed Medications: HYDROMORPHONE (DILAUDID, EXALGO), CYCLOBENZAPRINE (FLEXERIL), METHADONE (METHADOSE),

More information

VNSNY CHOICE FIDA Complete Step Therapy Requirements. Effective: 01/01/2017

VNSNY CHOICE FIDA Complete Step Therapy Requirements. Effective: 01/01/2017 Effective: 01/01/2017 Updated 11/2016 ANTI-INFLAMMATORY AGENTS - GI DIPENTUM PRIOR CLAIM FOR BALSALAZIDE OR APRISO WITHIN THE PAST 120 DAYS. ANTICONVULSANTS APTIOM BANZEL FYCOMPA GABITRIL OXTELLAR XR POTIGA

More information

2018 PDP Premier Step Therapy Document September 2018 Y0114_18_33144_I_009

2018 PDP Premier Step Therapy Document September 2018 Y0114_18_33144_I_009 2018 PDP Premier Step Therapy Document September 2018 Aggrenox Y0114_18_33144_I_009 aspirin 25 mg-dipyridamole 200 mg capsule,ext.release 12 hr multiphase drug may be given. Step 1 Drug(s): clopidigrel.

More information

PROCEDURE REF NO SABP/EXECUTIVE BOARD/0017

PROCEDURE REF NO SABP/EXECUTIVE BOARD/0017 PROCEDURE REF NO SABP/EXECUTIVE BOARD/0017 NAME OF GUIDELINE REASON FOR GUIDELINE WHAT THE GUIDELINE WILL ACHIEVE? WHO NEEDS TO KNOW ABOUT IT? Medicines Guideline: Hypnotic Medication Compliance with NICE

More information

Psychotropic Strategies Handout Package

Psychotropic Strategies Handout Package Psychotropic Strategies Handout Package Psychotropic Strategies Learning Objectives Utilize all clinical information available Assess the patient s overall condition this is essential Basic Principles

More information

Joint Formulary for Psychotropic Medication.

Joint Formulary for Psychotropic Medication. Joint for Psychotropic Medication. This document has been produced in collaboration with the Lancashire Commissioning Support Unit Page 1 Table of Contents Section Page Number Page 2 Definition of categories

More information

Formulary and Clinical Guideline Document Pharmacy Department Medicines Management Services

Formulary and Clinical Guideline Document Pharmacy Department Medicines Management Services Formulary and Clinical Guideline Document Pharmacy Department Medicines Management Services DRIVING AND MENTAL HEALTH CONDITIONS AND TREATMENTS General information Driving while impaired by a physical

More information

Guidelines/Supporting Studies* FDA Label Information Additional Information/Commentsxc` Gene(s)/Level of evidence

Guidelines/Supporting Studies* FDA Label Information Additional Information/Commentsxc` Gene(s)/Level of evidence Drug Gene(s)/Level of evidence Guidelines/Supporting Studies* FDA Label Information Additional Information/Commentsxc` Haloperidol CYP2D6 ( SLC6A5 ( 2D6: DPWG guidelines Reduce dose by 50% in PMs Aripiprazole

More information

Appendix A: Potentially Inappropriate Prescriptions (PIPs)

Appendix A: Potentially Inappropriate Prescriptions (PIPs) Appendix A: Potentially Inappropriate Prescriptions (PIPs) for older people (modified from STOPP/START 2 O Mahony et al 2014) Consider holding (or deprescribing - consult with patient): 1. Any drug prescribed

More information

Therapeutic Drugs Monitoring TDM 2018 Therapeutic Drugs Monitoring Scheme Application Form

Therapeutic Drugs Monitoring TDM 2018 Therapeutic Drugs Monitoring Scheme Application Form complete all sections below and return to LGC Standards Proficiency Testing by email, fax or post. Returning customer Lab ID: TM Purchase order no.: (compulsory) TDM Distribution Schedule Samples for the

More information

Prescriber s Guide. Stahl s Essential Psychopharmacology

Prescriber s Guide. Stahl s Essential Psychopharmacology Stahl s Essential Psychopharmacology Prescriber s Guide FIFTH EDITION With the range of psychotropic drugs expanding and the usages of existing medications diversifying, we are pleased to present this

More information

Prescribing Drugs to the Elderly

Prescribing Drugs to the Elderly Answers to your questions from University of Toronto experts Prescribing Drugs to the Elderly Can drugs do more harm than good? M.A. is a 90-year-old man living at home. He has dementia and due to wandering

More information

Step Therapy Requirements. Effective: 03/01/2015

Step Therapy Requirements. Effective: 03/01/2015 Effective: 03/01/2015 Updated 02/2015 ANTI-INFLAMMATORY AGENTS - GI DIPENTUM PRIOR CLAIM FOR BALSALAZIDE OR APRISO WITHIN THE PAST 120 DAYS. ANTICONVULSANTS APTIOM BANZEL FYCOMPA OXTELLAR XR POTIGA QUDEXY

More information

ANTICONVULSANTS. Details

ANTICONVULSANTS. Details ANTICONVULSANTS APTIOM 200 MG TABLET APTIOM 400 MG TABLET APTIOM 600 MG TABLET APTIOM 800 MG TABLET BANZEL 200 MG TABLET BANZEL 40 MG/ML ORAL SUSPENSION BANZEL 400 MG TABLET FYCOMPA 0.5 MG/ML ORAL SUSPENSION

More information

This document has been produced in collaboration with the Lancashire Commissioning Support Unit

This document has been produced in collaboration with the Lancashire Commissioning Support Unit Joint for Psychotropic Medication. This document has been produced in collaboration with the Lancashire Commissioning Support Unit Date: December 2014. Reviewed August 2016. Next review Date April 2019

More information

FORMULARY AND PRESCRIBING GUIDELINES 2017

FORMULARY AND PRESCRIBING GUIDELINES 2017 FORMULARY AND PRESCRIBING GUIDELINES 2017 1 Document Control Summary Issue Date Amended Section /page Author/ Amended by 1. Sept 06 All Jane Moriba Summary of Change Removed Trust policy and guideline

More information

ANTICONVULSANTS. Details

ANTICONVULSANTS. Details ANTICONVULSANTS Aptiom 200 mg tablet Aptiom 400 mg tablet Aptiom 600 mg tablet Aptiom 800 mg tablet Banzel 200 mg tablet Banzel 40 mg/ml oral suspension Banzel 400 mg tablet Fycompa 0.5 mg/ml oral suspension

More information

Interventions for acute depression study characteristics. Abbreviations Australia bipolar I disorder. Great Britain

Interventions for acute depression study characteristics. Abbreviations Australia bipolar I disorder. Great Britain APPENDIX 16: INTERVENTIONS FOR ACUTE DEPRESSION STUDY CHARACTERISTICS 1.1 Pharmacological interventions... 2 1.2 Nutritional interventions... 7 1.3 Physical interventions... 7 Abbreviations BPI CHN Dur

More information

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE

NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE SCOPE NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE 1 Guideline title SCOPE Neuropathic pain pharmacological management: the pharmacological management of neuropathic pain in adults in non-specialist

More information

Application for Endorsement of CQI (Clinical Audit) Activities for MOPS Credits Allocation

Application for Endorsement of CQI (Clinical Audit) Activities for MOPS Credits Allocation Application for Endorsement of CQI (Clinical Audit) Activities for MOPS Credits Allocation Below is the form you need to fill out. NAME Dianne Vicary Health Hawke s Bay DATE JUNE 2012 TITLE OF ACTIVITY

More information

2019 Simply Step Therapy Document

2019 Simply Step Therapy Document Aggrenox 2019 Simply Step Therapy Document AGGRENOX 25 MG-200 MG CAPSULE, EXTENDED aspirin 25 mg-dipyridamole 200 mg capsule,ext.release 12 hr multiphase drug may be given. Step 1 Drug(s): clopidigrel.

More information

PSYCHOTROPIC SOLUTIONS

PSYCHOTROPIC SOLUTIONS PSYCHOTROPIC SOLUTIONS A proactive approach to antipsychotic medication management A Quality Use of Medicines initiative by Choice Aged Care Copyright 2018 Key Senate Committee Recommendations: All RACF

More information

Appendix: Psychotropic Medication Reference Tables

Appendix: Psychotropic Medication Reference Tables Appendix: Psychotropic Medication Reference Tables How to Use these Tables These reference tables are designed to provide clinic staff with specific medication related criteria for the Polypharmacy, Cardiometabolic

More information

Impact of Frailty in HF

Impact of Frailty in HF Impact of Frailty in HF Biykem Bozkurt, MD, FACC The Mary and Gordon Cain Chair & Professor of Medicine Medical Care Line Executive, DeBakey VA Medical Center, Director, Winters Center for HF Research,

More information

St Francis Hospice. How common is it? How is it prevented? 10/07/2017. What is delirium? DSM IV criteria. Delirium vs Dementia.

St Francis Hospice. How common is it? How is it prevented? 10/07/2017. What is delirium? DSM IV criteria. Delirium vs Dementia. What is delirium? DSM IV criteria St Francis Hospice Dr Hilary Kinsler Disturbance of consciousness reduced clarity of awareness of the environment Change in cognition memory deficit, disorientation, language

More information

Behavioral and Psychological Symptoms of dementia (BPSD)

Behavioral and Psychological Symptoms of dementia (BPSD) Behavioral and Psychological Symptoms of dementia (BPSD) Chris Collins - Old Age Psychiatrist, Christchurch chris.collins@cdhb.health.nz Approaching BPSD: the right mindset Assessment Non-drug management

More information