High-risk medications in older adults drug alternative(s)
|
|
- Myrtle Carmella Kennedy
- 6 years ago
- Views:
Transcription
1 Antianxiety Analgesics Antihypertensive High-risk medications in older adults drug alternative(s) Guanabenz Guanfacine Methyldopa Reserpine (greater than 0.1 mg per day) High risk of adverse central nervous system (CNS) effects May cause bradycardia and orthostatic hypotension Not recommended as routine treatment for hypertension use as an antihypertensive Hypertension: Angiotensin converting enzyme inhibitor Angiotensin receptor blocker Thiazide Long acting dihydropyridine CCB Thiazide type diuretics or CCB for African Americans Mild pain: APAP (OTC) Ketorolac Indomethacin Increases risk of gastrointestinal bleeding and peptic ulcer disease in high-risk groups Moderate or severe pain: Morphine (G) Hydrocodone/APAP (Vicodin ) (G) Oxycodone/APAP (Percocet ) (G) chronic use. Meprobamate Dependence Sedation Anxiety: Buspirone (Buspar ) (G) SSRI (G) except paroxetine SNRI (G) * Formulary tiers vary by plan. Please check your patient s benefits for formulary status and coverage of Medication and Dosage Form. In some instances, when generics are available, the brand product may not be covered. Amerigroup STAR+PLUS MMP (Medicare-Medicaid Plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees. TXD-NL B 29264MUPENMUB April 2017
2 Antiparkinson agents Antiemetics Antidepressants Anticholinergics (includes combination products) Brompheniramine Chlorpheniramine Clemastine Dexbrompheniramine Dexchlorpheniramine Diphenhydramine Doxylamine Hydroxyzine Promethazine Paroxetine Highly anticholinergic (clearance reduced with age) Anticholinergic effects Sedation Orthostatic hypotension Delirium (use of diphenhydramine in situations such as acute severe allergic reactions may be appropriate) Allergic rhinitis: Intranasal normal saline Fexofenadine (Allegra ) (OTC) Cetirizine (Zyrtec ) (OTC) Intranasal steroid (G) (e.g., beclomethasone and fluticasone [OTC]) Pruritus: Topical agents: menthol and camphor, oatmeal baths, and calamine lotion (OTC) Antiemetic: See antiemetic section. Alternate SSRIs: Citalopram (20 mg per day) tier one Escitalopram (10 mg per day) tier two Sertraline (50 mg per day) tier one Alternate antidepressant: Mirtazapine (15-45 mg daily) tier two Trimethobenzamide Low efficacy Extrapyramidal adverse effects Ondansetron (Zofran ) (G) Benztropine (oral) Trihexyphenidyl Not recommended for prevention of extrapyramidal symptoms with antipsychotics More effective options are available for Parkinson s disease Parkinson s disease: Carbidopa/Levodopa (Sinemet, Sinemet CR) (G) Amantadine (G) tremor antipsychotics for behavioral problems of dementia unless nonpharmacologic options have failed and patient is a threat to themselves or others. Antipsychotics are associated with increased risk of cerebrovascular accident (stroke) and mortality in persons with dementia. Page 2 of 7
3 Antithrombotics Antispasmodics Antipsychotics typical Risperidone (Risperdal ) (G) Haloperidol (Haldol ) (G) Thioridazine Mesoridazine Atropine Dicyclomine Scopolamine Belladonna alkaloid Hyoscyamine Clidinium- Chlordiazepoxide Propantheline Ticlopidine Dipyridamole (oral and short acting) does not apply to the extended-release combination with aspirin Highly anticholinergic Risk of QT interval prolongation For atropine, gastric emptying is significantly slowed in elderly patients Scopolamine patch can cause increased confusion, memory deficits and dementia Anticholinergic effects increase the risk of delirium, urinary retention, agitation and blurred vision Drug class associated with memory deficits, confusion, dry mouth and worsening dementia Safer effective alternatives are available May cause orthostatic hypotension More effective alternatives are available antipsychotics for behavioral problems of dementia unless nonpharmacologic options have failed and patient is a threat to themselves or others. Antipsychotics are associated with increased risk of cerebrovascular accident (stroke) and mortality in persons with dementia. Antispasmodics: Baclofen (10 mg) tier two Antidiarrheal: Loperamide (2 mg) tier four Increase fiber Probiotics Motion sickness: Pressure band Ginger Stroke prevention: Low-dose Aspirin (OTC) Clopidogrel (Plavix ) (G) Aspirin/extended-release Dipyridamole (Aggrenox ) PCI: Clopidogrel (Plavix ) (G) Page 3 of 7
4 Cardiovascular agents other Calcium channel blockers Barbiturates Amobarbital Butabarbital Butalbital Mephobarbital Phenobarbital Pentobarbital High rate of physical dependence Tolerance to sleep benefits Risk of overdose at low dosages Sleep: Sleep hygiene caffeine and alcohol before bedtime Trazodone (Desyrel )(G) Ramelteon (Rozerem )(G) OTC melatonin (less than 15 mg total per day) Migraine: APAP (OTC) For epilepsy: Other anticonvulsants (e.g., lamotrigine and levetiracetam) Nifedipine (short acting only) Hypotension Risk of precipitating myocardial ischemia Nifedipine ER (long acting) (Procardia XL ) (G) Long acting dihydropyridine CCB (e.g., amlodipine) Disopyramide Digoxin (greater than mg per day) in heart failure A potent negative inotrope may induce heart failure in older adults Strongly anticholinergic In heart failure, higher dosages associated with no additional benefit and may increase risk of toxicity Slow renal clearance Atrial fibrillation: Nondihydropyridine CCB betablocker (e.g., diltiazem) for rate control Dofetilide flecainide, propafenone for rhythm control Heart failure: Digoxin (average daily dose of less than or equal to mg daily) dose reduction with monitoring Page 4 of 7
5 Narcotics (includes combination products) Hypnotics Hormones Estrogen (oral and topical patch) with or without progestin Carcinogenic potential Lack of cardioprotective effect and cognitive protection in older women Hot flashes: Cool environment, layered clothing and cool compress SSRI except paroxetine SNRI venlafaxine IR (Effexor ) (G) Gabapentin (Neurontin ) (G) Dyspareunia and vulvovaginitis: Vaginal estrogen formulations Nonbenzodiazepine hypnotics use of greater than 90 days: Eszopiclone Zaleplon Zolpidem Meperidine Adverse events similar to those of benzodiazepines in older adults (e.g., falls and delirium) Minimal improvement in sleep latency and duration Not an effective oral analgesic in dosages commonly used May cause neurotoxicity Safer alternatives are available chronic use (greater than 90 days) Bone density: Calcium/vitamin D (OTC) Bisphosphonates (G) Sleep: Sleep hygiene caffeine and alcohol before bedtime Trazodone (Desyrel ) (G) Ramelteon (Rozerem ) (G) Melatonin (less than 15 mg total per day) (OTC) For acute moderate to severe pain: Tramadol (Ultram ) (G) Morphine (G) Oxycodone/APAP (Percocet ) (G) Pentazocine Causes more adverse CNS effects than other narcotic drugs Mixed agonist and antagonist Safer alternatives available For chronic moderate to severe pain: Morphine (G) Hydrocodone/APAP (Vicodin ) (G) Oxycodone/APAP (Percocet ) (G) Tramadol (Ultram ) (G) long-duration, sustained-release dosage forms in opioid-naïve individuals. Page 5 of 7
6 Antidepressants (single agent or as part of a combination product) Skeletal muscle relaxants (as a single agent or in combination) Oral hypoglycemics Glyburide Prolonged hypoglycemia Glimepiride (Amaryl ) (G) Glipizide (Glucotrol ) (G) Metformin (Glucophage ) (G) Glipizide/metformin (Metaglip ) (G) Cyclobenzaprine Carisoprodol Chlorzoxazone Metaxalone Methocarbamol Orphenadrine Amoxapine Amitriptyline Clomipramine Desipramine Doxepin (greater than 6 mg per day) Imipramine Nortriptyline Paroxetine Trimipramine Protriptyline Poorly tolerated by older adults because of anticholinergic adverse effects, sedation and risk of fracture Questionable efficacy at doses tolerated by the elderly Anticholinergic effects Sedation Orthostatic hypotension Delirium Nondrug therapy: Physiotherapy Corrective seating and footwear Spasticity: Baclofen (Lioresal ) (G) Tizanidine (Zanaflex ) (G) Depression: Sertraline (Zoloft) (G) SNRI (G) Bupropion (Wellbutrin )(G) Neuropathic pain: Duloxetine (Cymbalta ) Venlafaxine (Effexor ) (G) Gabapentin (Neurontin ) (G) Capsaicin topical Sleep: Sleep hygiene caffeine and alcohol before bedtime Trazodone (Desyrel )(G) Ramelteon (Rozerem )(G) Melatonin (less than 15 mg total per day) (OTC) Page 6 of 7
7 Others (thyroid drugs, urinary anti-infectives) Desiccated thyroid Concerns about cardiac effects Safer alternatives are available Levothyroxine (Levoxyl, Synthroid ) (G) Nitrofurantoin (chronic use) Potential for pulmonary toxicity Safer alternatives available Lack of efficacy in CrCl less than 60 ml per minute due to inadequate drug concentrations in the urine for long-term suppression in patients with CrCl less than 60 ml per minute Confirmed UTI: TMP-SMX (Bactrim DS ) (G) Ciprofloxacin (Cipro ) (G) Cephalexin (Keflex ) (G) Trimethoprim (G) This is for informational purposes only and should not be construed as treatment protocols or required practice guidelines. Diagnosis, treatment s, and the provision of medical care services for customers and enrollees is the responsibility of physicians and providers. (Last updated April 5, 2017.) Page 7 of 7
Potentially Inappropriate Medication Use in Older Adults 2015 Latest Research
Home Resources Potentially Inappropriate Medication Use in Older Adults 2015 Resources Potentially Inappropriate Medication Use in Older Adults 2015 Latest Research Drugs and Categories of Drugs What these
More informationAllergy: Levocetirizine (Xyzal) (F) Desloratadine (Clarinex) (NF) OTC Cetirizine (Zyrtec) (NF) OTC Loratadine (Claritin) (NF) Dexchlorpheniramine
Anticholinergics Brompheniramine Carbinoxamine Chlorpheniramine Clemastine Cyproheptadine Highly anticholinergic, clearance reduced with advanced age, and tolerance develops when used as hypnotic; greater
More informationQuality ID #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety
Quality ID #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety 2018 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Process DESCRIPTION:
More informationMeasure #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety
Measure #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety 2015 PHYSICIAN QUALITY REPTING OPTIONS F INDIVIDUAL MEASURES REGISTRY ONLY DESCRIPTION:
More informationMeasure #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety
Measure #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety 2017 OPTIONS FOR INDIVIDUAL MEASURES: REGISTRY ONLY MEASURE TYPE: Process DESCRIPTION:
More informationCOMMON DRUG RELATED PROBLEMS SEEN IN PACE AND MECHANISMS TO MITIGATE RISK
COMMON DRUG RELATED PROBLEMS SEEN IN PACE AND MECHANISMS TO MITIGATE RISK Robert L Alesiani, PharmD, CGP Chief Pharmacotherapy Officer CareKinesis, Inc. (a Tabula Rasa Healthcare Company) 2 3 4 5 Pharmacogenomics
More informationMeasure #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety
Measure #238 (NQF 0022): Use of High-Risk Medications in the Elderly National Quality Strategy Domain: Patient Safety 2016 PHYSICIAN QUALITY REPORTING OPTIONS FOR INDIVIDUAL MEASURES REGISTRY ONLY DESCRIPTION:
More informationProvider Toolkit PFFS/PPO
Provider Toolkit 2014 2015 Y0067_PR_PhysTlkt_0514_IA 05/14/2014 PFFS/PPO TABLE OF CONTENTS Sample Letter from Physician to Patient...4 HEDIS Quick Reference Guide...5 High Risk Medication Formulary Alternative
More informationMedications to avoid in the elderly
Medicationstoavoidintheelderly Description Medicationstoavoid 1 (nonformularyin2016) Adversesideeffects/concerns Formularyalternatives 2,3 Alphaagonists, central Analgesics Androgen Anti anxiety guanabenz
More informationDid you know that some medications can be harmful to people 65 years or older?
Did you know that some medications can be harmful to people 65 years or older? What s the risk? Some medications can be dangerous to people 65 years of age or older. As we age, our bodies change. These
More informationPennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016
Pennsylvania Academy of Family Physicians Foundation & UPMC 43rd Refresher Course in Family Medicine CME Conference March 10-13, 2016 Disclosures: Drugs in Older Adults: Beers Criteria Heather Sakely,
More informationKatee 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 informationFall Prevention in Hospice (A pharmacologic and nonpharmacologic approach)
Fall Prevention in Hospice (A pharmacologic and nonpharmacologic approach) Chinenye Emereole, Pharm.D. Clinical Pharmacist Hospice Pharmacy Solutions Objectives Assess and identify hospice patients who
More informationAGS. From THE AMERICAN GERIATRICS SOCIETY AGS 2015 BEERS CRITERIA
From THE AMERICAN GERIATRICS SOCIETY AGS 2015 BEERS CRITERIA This guide has been developed as a tool to assist healthcare providers in improving medication safety in older adults. The role of this guide
More informationUse of diphenhydramine in situations such as acute treatment of. treatment of Parkinson disease. Avoid
From THE AMERICAN GERIATRICS SOCIETY A POCKET GUIDE TO THE AGS 2015 BEERS CRITERIA This guide has been developed as a tool to assist healthcare providers in improving medication safety in older adults.
More informationProposed Changes to Existing Measures for HEDIS : Use of High-Risk Medications in the Elderly (DAE) and
Proposed Changes to Existing Measures for HEDIS 1 2020: Use of High-Risk Medications in the Elderly (DAE) and Potentially Harmful Drug-Disease Interactions in the Elderly (DDE) NCQA seeks comments on proposed
More informationGeri-PARDY! (2015 Beers Criteria) Pharmacology Edition
Geri-PARDY! Pharmacology Edition (2015 Beers Criteria) Aurelio Muyot, MD, AGSF, FACP Assistant Professor College of Osteopathic Medicine Touro University Nevada Objectives Review the 2015 Beers Criteria
More informationSupplementary Online Content
Supplementary Online Content Gray SL, Anderson ML, Dublin S, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. Published online January
More informationAmerican Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
CLINICAL INVESTIGATIONS American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults By the American Geriatrics Society 2015 Beers Criteria Update
More informationDRUGS THAT ACT IN THE CNS
DRUGS THAT ACT IN THE CNS Anxiolytic and Hypnotic Drugs Dr Karamallah S. Mahmood PhD Clinical Pharmacology 1 OTHER ANXIOLYTIC AGENTS/ A. Antidepressants Many antidepressants are effective in the treatment
More informationNeuro Basics SLO Practice (online) Page 1 of 5
Neuro Basics SLO Practice (online) Page 1 of 5 1) Biogenic amines include ACh, NE, EPI and? a) Melatonin b) Dopamine c) Serotonin d) Histamine e) All of the neurotransmitters listed are biogenic amines.
More informationChronic Obstructive Pulmonary Disease (COPD) Care Management Assessment
The questions in this brochure, based on the 2010 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report, 1 are designed to help healthcare professionals (specifically case/care managers)
More informationDementia Medications Acetylcholinesterase Inhibitors (AChEIs) and Glutamate (NMDA) Receptor Antagonist
Dementia Medications Acetylcholinesterase Inhibitors (AChEIs) and Glutamate (NMDA) Receptor Antagonist Medication Dosage Indication for Use Aricept (donepezil) Exelon (rivastigmine) 5mg 23mg* ODT 5mg Solution
More informationNorthSTAR. 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 informationAging and Geriatric Assessment March 31, 2008 Sharon Leigh, Pharm D. BCPS Providence ElderPlace
Aging and Geriatric Assessment Page 1 Aging and Geriatric Assessment March 31, 2008 Sharon Leigh, Pharm D. BCPS Providence ElderPlace I. Aging A. Demographics Age 65+ population 3.1 million 1900 31.2 million
More informationHigh risk medications in the elderly/ Beers criteria updates
High risk medications in the elderly/ Beers criteria updates Date- 9/9/2016 Matt Just, Pharm.D., CGP and Jordan Wolf, Pharm.D., CGP Thrifty White Pharmacy Wi-fi Information: NETWORK: EC-CTR PASSWORD: westgate252
More informationForensic Toxicology Scope of Testing and Detection Limits
Forensic Toxicology Scope of Testing and Detection Limits Table of Contents QUALITATIVE ANALYSES... 2 Volatile Screen by GC/FID... 2 Carbon Monoxide by Microdiffusion... 2 Ethylene Glycol by GC/MS... 2
More informationHave 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 informationAmerican Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
CLINICAL INVESTIGATION American Geriatrics Society 2019 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults By the 2019 American Geriatrics Society Beers Criteria Update
More informationPharmacist CE LESSON. Reducing and eliminating high-risk medications in older adults 1 OCTOBER 2015
By Tara Dymon, PharmD, BCACP, Clinical Pharmacist, Medicare Pharmacy Clinical Programs; Miranda Wilhelm, PharmD, Clinical Associate Professor, Southern Illinois University Edwardsville School of Pharmacy;
More informationSupplementary Online Content
Supplementary Online Content Renoux C, Vahey S, Dell Aniello S, Boivin J-F. Association of selective serotonin reuptake inhibitors with the risk for spontaneous intracranial hemorrhage. JAMA Neurol. Published
More informationReview 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 informationPsychotropic 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 informationPalliative 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 informationALAMEDA 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 informationSTOPP START Toolkit Supporting Medication Review in the Older Person
STOPP START Toolkit Supporting Medication Review in the Older Person STOPP: Screening Tool of Older People s potentially inappropriate Prescriptions START: Screening Tool to Alert doctors to Right (appropriate,
More informationIMPORTANT NOTICE. Changes to dispensing of some Behavioral Health Medications for DC Healthcare Alliance members
IMPORTANT NOTICE Changes to dispensing of some Behavioral Health Medications for DC Healthcare Alliance members These changes apply only to members covered under the DC Healthcare Alliance program Alliance
More informationAlaska 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 information90 dosage units per 90 days OR. Extended-release Formulations Ultram ER 90 dosage units per 90 days OR
Pre - PA Allowance 12 years of age or older Quantity Immediate-release Formulation Ultracet 720 dosage units per 90 days OR Ultram 720 dosage units per 90 days Extended-release Formulations Ultram ER 90
More informationObjectives. Polypharmacy and the Geriatric Patient: A Primer for the Orthopedic Nurse CONFLICT OF INTEREST
Polypharmacy and the Geriatric Patient: A Primer for the Orthopedic Nurse Presented by Eric Greenberg Pharm. D., CGP, BCPS, R.Ph. Clinical Pharmacist Hospital for Special Surgery CONFLICT OF INTEREST I
More informationPharmaceutical Interventions. Collaborative Model of Mental Health Care for Older Iowans Des Moines May 18, 2007
Pharmaceutical Interventions Collaborative Model of Mental Health Care for Older Iowans Des Moines May 18, 2007 Outline Overview Overview of initial workup and decisions in elderly depressed individual
More informationMedications Contributing to Falls. Kate Niemann, PharmD BCGP AuBurn Pharmacy
Medications Contributing to Falls Kate Niemann, PharmD BCGP AuBurn Pharmacy Why Are Falls Important? Leading cause of injury in elders Costs to the system (CDC, 2008) ER Visits: 2.2 million $28.2 billion
More informationMedications 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 informationPAIN. TREATMENT TABLES Analgesics. NON-OPIOID ANALGESICS Generic Name Trade Names (Examples) Duration Initial Dose
NON-OPIOID SHORT-ACTING LONG-ACTING **** O PAIN TREATMENT TABLES Analgesics NON-OPIOID ANALGESICS Generic Name Trade Names (Examples) Duration Initial Dose Tramadol 50 mg Ultram Every 4 hours 1-2 tabs,
More informationSupplementary Online Content
Supplementary Online Content Raebel MA, Newcomer SR, Reifler LM, et al. Chronic use of opioid medications before and after bariatric surgery. JAMA. doi:10.1001/jama.2013.278344 efigure. Opioid Dispensings
More informationDrugs Found in Medical Examiner Cases
s Found in Medical Examiner Cases 1,1 difluoroethane propellant in aerosols 10-Hydroxycarbazepine 11-Hydroxy Delta-9 THC 6-monoacetylmorphine 7-amino clonazepam acetaminophen acetone alpha-hydroxyalprazolam
More informationPotentially Harmful Drugs in the Elderly: Beers List
PL Detail-Document #311201 This PL Detail-Document gives subscribers additional insight related to the Recommendations published in PHARMACIST S LETTER / PRESCRIBER S LETTER December 2015 Potentially Harmful
More informationAmerican Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
SPECIAL ARTICLES American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults The American Geriatrics Society 2012 Beers Criteria Update Expert Panel
More informationInsomnia: Updates in Medical Management. Michael Newnam M.D.
Insomnia: Updates in Medical Management Michael Newnam M.D. Sleep Neurobiology Delicate balance of excitatory and inhibitory neurotransmitters that control the switch between wakefulness and sleep Circadian
More informationMedications: The Dark Side
Medications: The Dark Side Robert P. Smith, MD Potential Mechanisms of Drug Effects Metabolic effects Alterations of Immunologic factors in CNS Interference with synaptic transmission Excess dopaminergic
More informationOakwood Healthcare Low Cost Drug List for OHSCare & BCN
Oakwood Healthcare Low Cost Drug List for OHSCare & BCN ACETAMINOPHEN-CODEINE ELIXIR Analgesic 240 720 ACYCLOVIR CAP 200MG Antiviral 30 90 AKTOB 0.3% EYE DROPS Miscellaneous 5 15 ALBUTEROL INH SOL 0.083%
More informationGeriatric 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 informationINTOXICATION 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 informationMay 22, DAL: DAL SUBJECT: Hot Weather Advisory. Dear Administrator/Operator:
May 22, 2013 DAL: DAL 13-11 SUBJECT: Hot Weather Advisory Dear Administrator/Operator: The New York State Department of Health would like to remind you of our expectations regarding the protection of Adult
More informationINTOXICATION 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 information2/12/2016. Drugs and Dementia in the Hospice Patient. Jim Joyner, Pharm.D., C.G.P. Director of Clinical Operations Outcome Resources
Drugs and Dementia in the Hospice Patient Jim Joyner, Pharm.D., C.G.P. Director of Clinical Operations Outcome Resources 1 Drug Therapy: Targeted at Symptoms Cognitive: Impaired abstract thinking Impaired
More informationMentoring Session: Participant Cases
Handout for the Neuroscience Education Institute (NEI) online activity: Mentoring Session: Participant Cases The Case: 55-year-old patient with depression and anxiety The Question: What to do when antidepressants
More informationNatural Medicines Food-Drug Interactions and Other Interesting Stuff
Natural Medicines Food-Drug Interactions and Other Interesting Stuff Homeopathy Like treats Like More dilute = More potent Potentization serial dilutions Forrest Batz, PharmD Assistant Professor of Pharmacy
More information1/21/2016 UPDATE ON THE AMERICAN GERIATRICS SOCIETY 2015 BEERS CRITERIA DISCLOSURE OBJECTIVES AGING GOALS BEERS CRITERIA
UPDATE ON THE AMERICAN GERIATRICS SOCIETY 2015 BEERS CRITERIA DISCLOSURE I have no financial conflict of interest to disclose. Lacey Charbonneau, Pharm.D. PGY-1 Community Practice Resident Baptist Medical
More informationUse 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 informationJudges Reference Table for the March 2016 Psychotropic Medication Utilization Parameters for Foster Children
Judges Reference Table for the Psychotropic Medication Utilization Parameters for Foster Children Stimulants for treatment of ADHD Preschool (Ages 3-5 years) Child (Ages 6-12 years) Adolescent (Ages 13-17
More informationMedicine 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 informationGeriatric prescribing considerations
Geriatric prescribing considerations Melanie A. Dodd, Pharm.D., Ph.C., BCPS Associate Professor of Pharmacy in Geriatrics Vice-chair, Department of Pharmacy Practice and Administrative Sciences College
More informationGuide to Psychiatric Medications for Children and Adolescents
Guide to Psychiatric Medications for Children and Adolescents by Glenn S. Hirsch, M.D. The following guide includes most of the medications used to treat child and adolescent mental disorders. It lists
More information20.9 15.4 3.1 0.1 0.2 0.2 0.3 0.4 0.6 0.9 1.5 2.2 9.6 6.1 7.3 4.2 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050 All Ages Age 65+ Age 85+ Female 50.9% Male 49.1% Female
More informationMay Revised Urine Drug Screen Test Menu Effective mid-june Lauren Anthony, MD, MT(ASCP) SBB Medical Director, Allina Health Laboratory
May 2014 Lauren Anthony, MD, MT(ASCP) SBB Medical Director, Allina Health Laboratory Revised Urine Drug Test Menu Effective mid-june 2014 To better address the complexities of drug screening for different
More informationAntidepressant Medication Strategies We ve Come a Long Way or Have We? Who Writes Prescriptions for Psychotropic Medications. Biological Psychiatry
Antidepressant Medication Strategies We ve Come a Long Way or Have We? Joe Wegmann, PD, LCSW The PharmaTherapist Joe@ThePharmaTherapist.com 504.587.9798 www.pharmatherapist.com Are you receiving our free
More informationAppendix 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 informationManagement 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 informationCOMMONLY PRESCRIBED PSYCHOTROPIC MEDICATIONS NAME Generic (Trade) DOSAGE KEY CLINICAL INFORMATION Antidepressant Medications*
COMMONLY PRESCRIBED PSYCHOTROPIC MEDICATIONS NAME Generic (Trade) DOSAGE KEY CLINICAL INFORMATION Antidepressant Medications* Bupropion (Wellbutrin) Start: IR-100 mg bid X 4d then to 100 mg tid; SR-150
More informationInappropriate Medication Use in the Elderly
Inappropriate Medication Use in the Elderly Amanda Ilenin, Pharm.D. OhioHealth Dublin Methodist Hospital & OhioHealth Grady Memorial Hospital Kristian Navickas, Pharm.D. OhioHealth McConnell Heart Health
More informationNATIONAL 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 informationSchedule FDA & literature based indications
Psychotropic Medication List Recommended dosages are intended to serve only as a guide for children. Recommended doses are literature based. Clinicians should consult package insert of medications for
More informationHYSINGLA ER (hydrocodone bitartrate) Prior authorization is not required if prescribed by an oncologist.
Pre - PA Allowance None Prior authorization is not required if prescribed by an oncologist. Prior-Approval Requirements Age 18 years of age or older Diagnosis Patient must have the following: 1. Pain,
More informationAppendix: 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 informationMedications 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 information48 th Annual Meeting. Clinical Pearls: Depression, Insomnia and Bipolar Disorder DSM-5. Disclosure. Depression. Patient Case. Objectives 7/19/2014
48 th Annual Meeting Clinical Pearls: Depression, Insomnia and Bipolar Disorder DSM-5 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Published in 2013 Most published treatment guidelines
More informationCONTRAINDICATIONS TABLE
CONTRAINDICATIONS TABLE Generic Name Brand Name Contraindications Amphetamine Salts Adderall, Adderall XR Hypersensitivity to amphetamine, dextroamphetamine, or other sympathomimetic amines Advanced arteriosclerosis
More informationDuragesic Patch (fentanyl patch) Prior authorization is not required if prescribed by an oncologist
Pre - PA Allowance Quantity 30 patches every 90 days Prior-Approval Requirements Prior authorization is not required if prescribed by an oncologist Age 2 years of age or older Diagnosis Patient must have
More information3703 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 informationM 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 informationMedication Use in Older Adults
Medication Use in Older Adults F. Michael Gloth, III, MD, AGSF, FACP, CMD Clinical Professor Department of Geriatrics, Florida State University College of Medicine Associate Professor of Medicine Division
More informationNortriptyline vs amitriptyline in elderly
Nortriptyline vs amitriptyline in elderly Amitriptyline (Elavil ) vs other antidepressants - comparative analysis amitriptyline vs divalproate, amitriptyline vs trazodone. Learn what other patients are
More informationAnxiolytic, Sedative and Hypnotic Drugs. Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia
Anxiolytic, Sedative and Hypnotic Drugs Assistant Prof. Dr. Najlaa Saadi PhD Pharmacology Faculty of Pharmacy University of Philadelphia Anxiolytics: reduce anxiety Sedatives: decrease activity, calming
More informationChitra Fernando, MD March 18, 2008
Chitra Fernando, MD March 18, 2008 Definition Statistics Risk factors Why older adults are more prone to ADE Manifestations Inappropriate medications for older adults What can be done to minimize adverse
More informationMedicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay
Medicine Related Falls Risk Assessment Tool (MrFRAT) User Guide for Age Related Residential Care Facility Staff in Hawke s Bay (Revised edition November 2015) The Medicine Related Falls Risk Assessment
More informationManagement of Behavioral Problems in Dementia
Management of Behavioral Problems in Dementia Ghulam M. Surti, MD Clinical Assistant Professor Department of Psychiatry and Human Behavior Warren Alpert Medical School of Brown University Definition of
More informationHigh Risk Medications: What Can Community Pharmacists Do to Make Patients Safer?
CONTINUING EDUCATION High Risk Medications: What Can Community Pharmacists Do to Make Patients Safer? by Sean T. Lasota, PharmD Sept. 1, 2015 (expires Sept. 1, 2018) Activity Type: Knowledge-based To earn
More informationTranquilizers & Sedative-Hypnotics
Tranquilizers & Sedative-Hypnotics 1 Tranquilizer or anxiolytic: Drugs used therapeutically to treat agitation or anxiety Sedative-Hypnotic: drugs used to sedate and aid in sleep Original sedatives (before
More informationWELLCARE/ OHANA HEALTH PLAN 2015 STEP THERAPY CRITERIA (No Changes Made Since: 08/2015)
WELLCARE/ OHANA HEALTH PLAN 2015 STEP THERAPY CRITERIA (No Changes Made Since: 08/2015) **To get updated information about the drugs covered by WellCare/ Ohana, please visit our website (https://www.wellcare.com
More informationOXYCODONE IR (oxycodone)
RATIONALE FOR INCLUSION IN PA PROGRAM Background Oxycodone hydrochloride, a pure opioid agonist, is used in the treatment of moderate to severe pain (1-2). The precise mechanism of action is unknown; however,
More informationThe Use of Antidepressants in the Treatment of Irritable Bowel Syndrome and Other Functional GI Disorders What are functional GI disorders?
The Use of Antidepressants in the Treatment of Irritable Bowel Syndrome and Other Functional GI Disorders Christine B. Dalton, PA-C Douglas A. Drossman, MD and Kellie Bunn, PA-C What are functional GI
More informationStudy 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 informationProfessionalism & 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 informationPre - PA Allowance. Prior-Approval Requirements LEVORPHANOL TARTRATE. None
Pre - PA Allowance None Prior-Approval Requirements Prior authorization is not required if prescribed by an oncologist and/or the member has paid pharmacy claims for an oncology medication(s) in the past
More informationTreatment of Neuropathic Pain: What Does the Evidence Say? or Just the Facts Ma am
Treatment of Neuropathic Pain: What Does the Evidence Say? or Just the Facts Ma am Tim R Brown, PharmD, BCACP, FASHP Director of Clinical Pharmacotherapy Cleveland Clinic Akron General Center for Family
More informationBEERs For the Elderly
BEERs For the Elderly February 2008 Presented by:carla Ambrosini Seniors First Clinic Pharmacist 12/05/2008 1 Objectives To highlight the overall health care impact of drug related adverse reactions and
More informationDe-prescribing in Older Adults. Wael Hamade, MD, FAAFP 04/08/2016
De-prescribing in Older Adults Wael Hamade, MD, FAAFP 04/08/2016 DISCLOSURES None of the faculty, planners, speakers, providers nor CME committee has any relevant financial relationships with commercial
More information4/10/2013 DISCLOSURES
DISCLOSURES I have no financial relationship to disclose. 2012 BEERSCRITERIA AN UPDATE FOR GERIATRIC MEDICINE Charles Mosler, PharmD, CGP, FASCP Ohio Pharmacists Association Annual Conference and Trade
More information