Indacaterol inhalation powder (ArcaptaNeohaler) is soon to be availablefor chronic obstructive pulmonarydisease (COPD). The long-acting beta-2-adrenergic agonist provides once-dailydosing from a 75-mcg capsule, not to beingested orally. I found the drug’s uniqueinhalation device, with no moving parts,easy to load with the capsule and tomanipulate.

The drug... »

As of Jan. 1, skilled nursing facilities are being hit hard by the 11% cut in reimbursement for Medicare patients’ care. Also facing annual state reductions of 2%–4% in Medicaid payments, SNFs could experience tens of millions of dollars in financial shortfalls. A full understanding of pharmacy costs could help facilities make up a significant portion of... »

Nuedexta capsules containing 20 mg of dextromethorphan and 10 mg of quinidine sulfate are now indicated for the treatment of pseudobulbar affect. Quinidine increases the bioavailability of dextromethorphan more than 20-fold.

Although unfamiliar to many long-term care practitioners, the condition is characterized by uncontrolled and exaggerated crying or... »

Long-term care facilities are under significant pressure to control phar­macy costs and with good reason. They are the second highest costs for fa­cilities, behind only wages.

The LTC-pharmacy consulting firm I am part of, Senior PharmaStrategies, es­timates that drug-price inflation will be 4%-9% over the coming year. But don’t expect reimbursement to... »

Dabigatran Etexiltate

This direct thrombin inhibitor (Pradaxa), available in 75-mg and 150-mg capsules, is indicated to reduce the risk of stroke and systemic embolism in patients with nonvalvular atrial fibrillation.

For patients with creatinine clearance higher than 30 mL/min, the recommended oral dose is 150 mg twice a day. Doses may be given with or... »

Transdermal Buprenorphine

The Food and Drug Administration approved this transdermal patch for the management of moderate to severe pain in patients requiring a round-the-clock opioid analgesic for extended periods of time. Under the trade name Butrans (Purdue), the buprenorphine patch is designed to be worn for 7 days. This dosing schedule has pluses and... »

Insulin pens are expensive, whereas vials are cheap, right? You might be surprised to learn that the typical nursing facility could save thousands of dollars each year by going with the pens for diabetic residents.

The key is that 35%-40% of insulin in vials is wasted because pharmacy regulations typically say that a vial must be discarded 28 days after... »