This will be devastating to rural communities.

"As many of us have learned and all of us will learn, the difference between doctor and patient is only a matter of perspective." - This perspective remains lost on so many clinicians, quick to check off the box, write the note, order a medication. Thanks for sharing. #hapc

Grand Vizier - yes, Musk seems very Jafar-like. So twisted.

The risk associated with benzonatate use outweighs the benefits. Agents such as opioids (not codeine) or dextromethorphan have efficacy against cough with less risk of toxicity. When treating cough, just say NO to benzonatate - don't clutch your perles! #hpm #palliative #PalliSky #PharmSky

Benzonatate is an FDA "grandfathered" agent (1958). 1) No placebo-controlled RCTs demonstrating efficacy 2) structurally related to amino ester anesthetics like procaine 3) Unknown M.O.A., proposed - anesthetizing lung stretch receptors → suppresses cough reflex (Na+ channel blockade)

Should I use benzonatate (Tessalon Perles®) to treat cough?

Docusate (Colace) fits the Lown Institute criteria for a medication that is Never Necessary Prescribing - produces pill burden without any positive efficacy in opioid-induced constipation - bit.ly/3ru1Obl

Bro, that's why you can't use Colace for opioid-induced constipation. It is all mush and no push. Colace sucks! #palliative #pharmsky

A good reminder that a PPI is not needed for patients on high dose corticosteroids without other risk factors. PMID: 37013890. #TWDFNR #hapc #PalliRx #deprescribing