When Medicine Hurts: Treating Our Elderly

Medication is a two-edged sword. The same dose of a medication given to two different people may cure one and harm the other.

Medication, the silent epidemic can appear in a variety of ways – the right medication in the wrong dose, or two or more medications that interact with dangerous, unintended side effects.  Medication-related problems occur most often in older people and are generally more severe. (more…)

Budget Crisis in Oklahoma: Being Efficient With What You Have

A projected 25% cut in Medicaid provider payments could go into effect June 1 and elderly Oklahomans will be hit hardest in a state already ranked as worst in the country for healthcare access.

 

So the big question is…what can we do to help offset these budget cuts?

The Oklahoma Association of Health Care Providers said the cuts would likely leave more than 90% of the state’s nursing homes operating at a loss and in danger of closing. (more…)

Reducing Falls in Nursing Homes

Fall prevention in nursing homes continues to be a major focus for quality improvement in patient safety.

According to the Centers for Disease Control (CDC), medication management can reduce interactions and side effects that may lead to falls. Although many medication classes have been linked to falls, the evidence is strongest for a few drug categories.  For patients 65 or older, Eliminate medications if there is no active indication to use them, reduce doses of necessary medications (e.g., antihypertensives) to the lowest effective dose.  Avoid prescribing medications for an older person where the risk from side effects outweighs the benefit (e.g., skeletal muscle relaxants). MOST importantly, reduce or eliminate: Psychoactive drugs, especially any benzodiazepines.  Any medications with side effects like drowsiness, sedation, blurred vision, or confusion. Sedating over-the-counter (OTC) medications, specifically Benadryl and Tylenol PM, which contains Benadryl. (more…)

Pharmacogenetics: Valuable information for actionable treatment recommendations

PGx Medical test results provide clinicians with valuable patient-specific information to make better therapeutic treatment decisions.  

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The PGx Medical team works alongside healthcare professionals to implement pharmacogenetics in the Long Term Care setting.  A simple swab of the cheek will help healthcare providers manage medications by reducing unnecessary medications, or confirming residents are on the right medications and dosage.

Medications may be assessed in the following areas of clinical care:  hypertension, hyperlipidemia, arrhythmia, anti-coagulation, thrombophilia, depression, psychosis, anxiety, ADHD, pain (including musculoskeletal, arthritis, migraine and neuropathic), bipolar and seizure.

With the PGx Medical Metabolic Validation Program, via pharmagogenetic testing,  you will receive a customized patient report which includes personalized result interpretations and actionable treatment recommendations.

For more information, contact:
PGx Medical
Individualized Care – Personalized Medicine
405-509-5112
info@pgxmed.com

Dementia Patients and Antipsychotic Medications

Pharmacogenomic testing is an evidence-based tool that provides information about a patient’s response to medications and can help guide healthcare professionals when dosing medications.

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According to the new guidelines from the American Psychiatric Association, healthcare providers should focus on “judicious” use of antipsychotic medications when treating people with dementia.

The guidelines, published this week in the American Journal of Psychiatry, acknowledge antipsychotics can be appropriate for people with dementia who exhibit severe or agitation or psychosis. But providers should assess each patient’s symptoms and and possible nonpharmacological interventions before administering the drugs, experts cautioned.

“Over the last few years there have been a number of additional studies that suggest there can be harms with these medications,” author Laura Fochtmann, M.D., told MedPage Today. “As the number of older individuals with dementia increases, we want to be assured that patients are getting the most appropriate form of treatment.”

The guidelines include recommendations to taper and eventually discontinue antipsychotic use if patients experience significant side effects or see no significant response after a 4-week trial. Patients who show an “adequate” response to antipsychotics should also have their doses tapered within 4 months of starting on the drug, unless they exhibit a recurrence of symptoms during tapering or withdrawal, the authors said.

With pharmacogenomic testing, healthcare professionals can avoid the “trial and error” or guessing game.  They will have an evidence based tool to help guide them in dosing.

“You don’t always have the luxury of waiting 4-6 weeks when you are dealing with a patients who is agitated or displaying aggression.  To wait 4 weeks and find out the medication isn’t working, or that the medication you gave them is having an adverse reaction with another medication they are taking, that is hard on everyone,” said Clay Bullard, President of PGx Medical.

PGx Medical is headquartered in Oklahoma but offers education and implementation of their Metabolic Validation Program across the country.  “Our program is designed to help healthcare professionals avoid the “trial and error” process and offer their patients more precise, pinpoint therapy.  By knowing which medications a patient has the ability to metabolize properly, allows the healthcare provider to accurately prescribe medications.  That doesn’t mean they won’t have side effects from that medication, it just means their body will metabolize the medications the way the drug manufacturer intended, therefore giving them therapy.”

Bullard went on to say, “dementia patients can’t always tell you if their medications are, or are not working.  So to have a customized patient report which includes personalized result interpretations and actionable treatment recommendations for each patient, it really helps shorten the timeframe giving that individual therapy a lot sooner.”

When a dementia patient is treated with medications that work and lessens the agitation and aggression, it may help offset the fatigue and burnout on the staff and caregivers.

For more information on the PGx Medical Metabolic Validation Program, contact:

PGx Medical
Individualized Care – Personalized Medicine
info@pgxmed.com
405-509-5112

Source:
American Psychiatric Association
American Journal of Psychiatry
MedPage Today