We have come to the end of the year! Hope you all had a fruitful year. Do catch us next year with more updates! From all of us at the Hospital Chapter, we wish you a blessed Christmas and a fantastic 2016 ahead! Keep reading and accumulate CPE points! Remember to renew your PSS membership to continue to enjoy the Pharmacist Letter updates.

Please log on to the PSS website (www.pss.org.sg) and access Pharmacist Letter to read the updates!

Topic of the month: Appropriate Medication Use in Older Adults: 2015 Updated Beers Criteria

With the American Geriatrics Society Beers Criteria or “Beers list” in its fifth permutation, clinicians in outpatient and inpatient settings (but not hospice or palliative care) can use it to improve the care of patients 65 years of age and older. New to the 2015 version is a list of potentially harmful drug-drug interactions in seniors, as well as a list of medications that may need to be avoided or their dosage reduced based on renal function. An additional tool for improving care in the elderly is the START and STOPP criteria. Resources and toolkits are available in this article.

Clinical Updates:

1) Managing Bleeding with the New Oral Anticoagulants: Specific reversal agent (monoclonal antibody), Praxbind (idarucizumab), is now FDA-approved for dabigatran reversal. Review its indications and uses in this PL update, along with the management of bleeding associated with new oral anticoagulants.

CHART: Managing Bleeding with the New Oral Anticoagulants

2) Tiotropium (Spiriva) for Asthma: Learn about the role of tiotropium in the management of persistent asthma and the use of Spiriva Respimat (tiotropium). See our PL Toolbox, Improving Asthma Care, for educational materials, asthma guidelines, and more.

3) Opioid Discontinuation: With careful patient selection, education, and monitoring, opioids can be safe and effective tools to improve function and pain intensity in chronic non-cancer pain. Learn about ways to approach this challenging patient care situation. See our PL Chart, Management of Opioid Dependence, for help in identifying opioid use disorder and information on pharmacotherapy options.

Frequently Asked Questions at the Community Pharmacy:

1. Supplements and herbs are all natural, so they should be safe right?

Click here to check out some tips and resources that will help your patients be savvy dietary supplement users.

2. Let’s celebrate the holiday season with some alcohol! But wait can I take my medications and drink alcohol at the same time?

Know your medicines and their interactions. Check out the PL Chart Alcohol and Drug Interactions.