Do not prescribe immune suppressive agents for suspected autoimmune hepatitis (AIH) without first excluding hepatotropic virus infections (e.g., viral hepatitis A, B, and C). Viral hepatitis may mimic AIH, both serologically and histologically, features that may resolve with direct-acting antiviral (DAA) treatment. Posted November 3rd, 2022 by Nick Mackara & filed under .
ASCP10-Don’t use strong CYP3A4 and P-glycoprotein inhibitors or inducers with Direct Oral Anticoagulants (DOACs) and periodically assess the medication regimen for such drug-drug interactions. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP9-Don’t prescribe tramadol for older adults without due consideration of the potential risks and harms related to serotonergic excess, seizures, falls and drug-drug interactions. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP8-Don’t combine opioids with benzodiazepines or gabapentinoids to treat pain in older adults and re-evaluate routinely for deprescribing during chronic use. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP7-Don’t use three or more CNS-active medications (antidepressants, benzodiazepines, Z-drugs, opioids, gabapentinoids, antipsychotics, antiepileptics), especially in older adults. Posted June 8th, 2022 by Nick Mackara & filed under .
ASCP6-Don’t prescribe or routinely continue medications for older adults with limited life expectancy without due consideration to individual goals of care, presence of comorbidities and time-to-benefit for preventive medications. Posted June 8th, 2022 by Nick Mackara & filed under .
SHMAM6- Avoid using opioids for treatment of mild, acute pain. For moderate to severe acute pain, if opioids are used, it should be in conjunction with non-opioid methods with the lowest effective dose for the shortest required duration. Posted May 31st, 2022 by Nick Mackara & filed under .
Don’t prophylactically use compounded antibiotic soaks for aftercare following office-based procedures (e.g., nail and skin lesion removal). Posted January 20th, 2022 by Nick Mackara & filed under .
Don’t prescribe neuropathic pain agents for painless neuropathy. Posted January 20th, 2022 by Nick Mackara & filed under .
ASCP5-Don’t use two or more medications that are known to increase the risk of bleeding without evaluating the potential risks and benefits. These medications include direct oral anticoagulants (DOACs), warfarin, aspirin, selective serotonin reuptake inhibitors (SSRIs), antiplatelet agents, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids. Posted May 17th, 2021 by Nick Mackara & filed under .
ASCP4-Don’t use anticholinergic medications concomitantly with cholinesterase inhibitors in patients with dementia. Posted May 17th, 2021 by Nick Mackara & filed under .
ASCP3-Don’t recommend highly anticholinergic medications in older adults without first considering safer alternatives or non-drug measures. Posted May 17th, 2021 by Nick Mackara & filed under .
ASCP2-Don’t continue medications at transitions of care without a pharmacist or other qualified health care professional performing a comprehensive medication review to verify accurate and complete medication information in concert with current medical problems. Posted May 17th, 2021 by Nick Mackara & filed under .
ASCP1-Don’t initiate medications to treat new and emerging symptoms without first ascertaining that the new symptom is not an adverse drug event of an already prescribed medication. Posted May 17th, 2021 by Nick Mackara & filed under .
SCCM3-Don’t continue antibiotic therapy without evidence of need. Posted February 1st, 2021 by Nick Mackara & filed under .
