Preston Pharmacy News - December 2011

Pharmacy Holiday Hours

Preston Pharmacy will be closed Monday December 26 and Monday January 2 in observance of Christmas and the New Year holiday. The pharmacy will be open normal business hours each Saturday prior to the holidays.

KDOA Roundtable Discussion

Last month a roundtable was held by the Kansas Department of Aging survey team to elaborate on the top ten deficiencies noted in nursing home facilities. The following notes were taken by Angie Little, PharmD and should be used only for quality improvement measures
F-329: Unnecessary medications
--No monitoring parameters in place for side effects, black box warnings, med effectiveness
--Gradual Dose Reductions (GDRs) not being attempted/ Risk vs. Benefit statements
--PRN Reason/Result documentation
F-371: Kitchen Sanitation
F-279: Comprehensive Care Plan
--Individualized Care Plans need to have measurable goals that are revised often
--Discharge Care Plans must be done
F-323: Accident Reporting
--See KDOA website for appropriate reasons to report and how to do so
--Parameters should be in place to make accidents AVOIDABLE
F-280: Complete investigations must be documented and records should be kept
F-312: ADLs
--Consistency of care should be documented to avoid decline in condition
F-309: Lack of Coordination of Care
--eg. Hospice, home health, dialysis, clinics, etc
F-441: Infection Control
--Staff awareness of proper procedures, protocols, precautions, etc.
F-334: Education prior to vaccination
--Vaccine Information Sheet, signed consent
F-428: Pharmacy Report
--Pharmacist must document and report irregularities
--Nursing facility staff must follow up and take action on these reports

Other notable tags included F-314 (pressure sores), F-241 (dignity), and F-242 (choices for residents). The DOMINO EFFECT was also discussed whereby findings in one area can lead to another deficiency and more ‘tags’.

High-Risk Medications in Elderly

A recent study conducted by the CDC and published in the New England Journal of Medicine found that four medication classes contributed to two-thirds of emergency hospitalizations secondary to adverse drug events in patients 65 years or older. Warfarin accounted for 33% of emergency hospitalizations, insulin = 14%, antiplatelet drugs (aspirin or clopidogrel) =13%, and oral hypoglycemic agents =11%. While these medications are usually necessary in the elderly, they should be monitored closely.¹

Medication Safety

Dangerous Drug Interaction²
Theophylline and Quinolones (ciprofloxacin, levofloxacin, moxifloxacin) – may result in theophylline toxicity. Monitor and maintain theophylline levels within therapeutic range; toxicity may still occur with levels in targeted range. Signs and symptoms of theophylline toxicity include seizures, nausea, and vomiting.

Look-Alike and Sound-Alike Names³
Jantoven confused with Janumet
Jantoven confused with Januvia
Janumet confused with Januvia
Janumet confused with Sinemet
K-Phos Neutral confused with Neutra-Phos-K
Kaletra confused with Keppra
Keflex confused with Keppra

Joke of the Month

Where do snowmen go to dance?
---A snow ball!

References for December, 2011 Issue

Centers for Disease Control and Prevention. Elderly at risk of hospitalizations from key medications [press release]. Available at: http://www.cdc.gov/media/releases/2011/p1123_elderly_risk.html. Accessed November 29, 2011.
Top ten drug interactions most dangerous to seniors in long-term-care. Available at: http://www.drugdanger.com/Elderly/4-12-14DrugInteractions.htm. Accessed September 27, 2011.
Institute for Safe Medication Practices. ISMP’s list of confused drug names. Available at: http://www.ismp.org/tools/confuseddrugnames.pdf. Accessed April 19, 2011.

Download

Download our newsletter for reading at a later time.

December, 2011