The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists
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Opioid analgesics are commonly used medications for the treatment of acute and chronic pain syndromes associated with multiple disease states. However, their use is often limited by adverse effects. Opioid-induced pruritus (OIP) is one of the most common adverse effects, affecting patients on oral and neuraxial opioids. ⋯ The occurrence of pruritus varies with the type of opioid, dose, and method of administration. Pharmacists can make interventions that will optimize control of, or reduce the incidence of, OIP. An understanding of the receptors, mechanisms, incidence, and pharmacological therapies available to manage OIP is required knowledge for practitioners caring for patients who use opioids.
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The Drug Enforcement Administration recently announced the final rule to reschedule hydrocodone combinations from schedule III of the Controlled Substances Act to the more restrictive schedule II category. This regulatory change will have broad operational implications for practitioners serving the health care needs of long-term care residents. Stakeholders will need to work collectively to identify possible efficiencies to counter some of the anticipated costs as well as its effect on patient care.
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The objective of this work is to improve the management of disruptive behavior in the nursing facility setting through an interdisciplinary team (IDT) approach to reduce the use of antipsychotic medications in accordance with the Centers for Medicare & Medicaid Services initiative. ⋯ Through an IDT, strategies can be implemented for long-term care residents to prevent and better manage disruptive behavior. These strategies can result in the reduction of the use of antipsychotic medications. The field of long-term care would benefit from further research to identify additional nonpharmacologic and pharmacologic treatments for managing disruptive behavior.
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Primary, to evaluate the usefulness of a comprehensive medication review (CMR) process in screening for adverse drug event (ADE) risk and to measure the impact of pharmacist recommendations; secondary, to evaluate whether screening tools assist in detecting ADEs. ⋯ Pharmacist-provided CMR services should be comprehensive, including patient's self-report of ADEs and history of ADEs. Pharmacist intervention can minimize prescription medication use, reducing the risk of ADEs.