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Inappropriate use of Fentanyl Patches

Inappropriate use of Fentanyl Patches

76 year old male had recently had a hip fracture with surgery and was in a substantial amount of pain.  Upon discharge from the hospital, he was admitted to a long term care facility for rehab. ...

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Discontinuing Medications in the Elderly

Discontinuing Medications in the Elderly

You're probably aware I'm an advocate for simple, rationale use of medications.  This means that at times we might consider reducing or discontinuing medications that may not be appropriate...

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Treating Delirium

Treating Delirium

I frequently have the challenge of sifting through hospital records to try to identify what's going on with a new admission to a long term care facility.  It can be a struggle to find pertinent...

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Colchicine May Cause Significant Diarrhea

Colchicine May Cause Significant Diarrhea

88 year old gentleman was having a difficult time with management of gout.  He was on chronic allopurinol therapy and had to use frequent as needed NSAIDs for repeat flares.  Steroid bursts also had...

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Controlled Substance Accountability

Controlled Substance Accountability

I've had the opportunity to work at over 50+ different healthcare facilities.  I've had the unfortunate opportunity to deal with my fair share of diversion and potential diversion cases.  It's not...

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Does Credentialing Really Matter?

Does Credentialing Really Matter?

I had a doctor a year or two ago ask for my input (off the record) on a patient that she was struggling with. Coumadin and INR management was the issue. I think I recall the term "roller coaster"...

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The Diuretic Effect

The Diuretic Effect

An 81 year old gentleman was struggling with CHF symtpoms.  Fluid overload was the problem with difficulty breathing secondary to increased edema/CHF symptoms.  His Lasix was increased from 20 mg...

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The 10 Commandments of Polypharmacy

The 10 Commandments of Polypharmacy

I work with patients, nurses, doctors, pharmacists and other healthcare professionals everyday who struggle with medication management. One of the biggest problems I run into is polypharmacy. Ten,...

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