June 2025

Any comments/suggestions please email the editor at editor@redrockrx.com

Edited by Malcolm Fraser MD, CMD

Busy Month at Red Rock: Key Updates + Big Wins!

I hope you all had a wonderful Memorial Day weekend and enjoyed some quality time with family and friends. Things have been busy here at Red Rock!

As a follow-up to last month’s review of the new NH Survey Guidance (effective April 28, 2025), we’ve received a helpful clarification: While the guidance states that a physician must evaluate a resident before renewing a 14-day PRN psychotropic medication, we’ve now confirmed that a midlevel provider may also conduct the required evaluation. The regulation allows for it to be performed by “the prescribing physician or prescribing practitioner.”

In other news, just before the holiday weekend, a major update to U.S. COVID-19 vaccine policy was announced through a New England Journal of Medicine perspective article. Moving forward, COVID-19 vaccines will be recommended only for individuals over 65 or for younger adults with at least one chronic condition. Since many under-65 residents have qualifying conditions (e.g., obesity, hypertension, diabetes), we anticipate that nearly all NH residents in this group will remain eligible. We’ll keep you informed as more guidance becomes available.

And finally—a big congratulations to Denver Pharmacy Manager Stacey Chang and her team on their outstanding survey performance on May 19, 2025. Way to go, team!

Shixian Wang

Director of Operations



Employee of the Month – June

We’re proud to recognize Rosemary as Red Rock Pharmacy’s Employee of the Month for June!

Since joining our Meridian branch in November 2021, Rosemary has made a lasting impression as our Lead Technician. Known for her strong work ethic and supportive spirit, she brings consistency, care, and leadership to the team every single day.

Rosemary joined Red Rock after hearing great things about the work environment—and she’s since become a key part of what makes our culture so special. She appreciates that at Red Rock, “we’re able to be ourselves,” and that authenticity shines through in her interactions with both colleagues and patients.

She thrives in a hands-on environment and loves continuously learning. Over the years, she’s sharpened critical skills like time management, teamwork, and multitasking, all of which contribute to her success as a technician and leader. Her motivation? “Being supportive to my team.”

Outside of work, Rosemary recharges by spending time with family and friends, being creative, and soaking up the sunshine whenever she can. And if she had to pick just one meal for life? It’s a toss-up between fajitas or tacos—can’t go wrong either way!



Thank you, Rosemary, for the energy, heart, and reliability you bring to Red Rock Pharmacy. We’re lucky to have you on our team!



Pharmacy Strategies to Support Memory Care

Medication adherence is a cornerstone of effective dementia care, yet in memory care units, it’s one of the most persistent challenges. Between cognitive decline, behavioral disturbances, and complex medication regimens, achieving a consistent and safe medication regimen requires more than reminders. At Red Rock Pharmacy, we understand these unique challenges and partner with assisted living and skilled nursing facilities to strengthen medication adherence strategies. Here are some evidence-informed approaches making a difference:

1. Simplify the Regimen

Residents with dementia are more likely to miss doses or refuse medications when faced with complicated schedules.

Solutions:

• Medication consolidation (e.g., once-daily formulations)

• Deprescribing unnecessary or duplicate medications

• Collaborating with providers for long-acting alternatives, such as injectables

2. Behavioral Approaches to Refusals

Dementia-related agitation can lead to repeated refusals.

Support strategies:

• Training staff on non-pharmacological calming techniques and documenting attempted methods

• Timing meds with meals or preferred activities

• Using distraction and redirection methods

3. Involve Families in the Process

Caregiver understanding and participation can dramatically improve outcomes.

What works:

• Educating families on why certain medications are needed

• Encouraging consistent language and routines across care settings

• Offering virtual or in-person med review consults through your pharmacy partner

4. Monitor and Adjust

Adherence isn’t set-it-and-forget-it. It requires continuous evaluation.

Best practices:

• Reviewing medication administration records (MARs) quarterly

• Using pharmacy reports to flag missed or refused doses

• Hosting regular clinical check-ins with nurses, providers, and pharmacy consultants

Final Thoughts

Dementia care is personal, emotional, and complex, but with the right strategies and pharmacy partner, medication adherence can improve dramatically. At Red Rock Pharmacy, we tailor our support to the specific needs of memory care communities. These techniques also incorporate the new regulations which surveyors will be looking for.

Dave Rimlinger

Director of Marketing

drimlinger@redrockrx.com

The first new type of antibiotic for Urinary Tract Infections in over 20 years

The US Food and Drug Administration has approved a new type of oral antibiotic to treat urinary tract infections. The pill, gepotidacin, a first-in-class triazacenapthylene antibiotic, will be sold under the brand name Blujepa and is expected to be available in the second half of 2025.

Blujepa is approved to treat females 12 and older (Ed. Note: NOT approved to treat males) with uncomplicated urinary tract infections (UTIs). About half of all women will experience a UTI at some point in their lives, and about 30% will have a UTI that recurs after treatment, drugmaker GSK said.

According to the package insert, Blujepa is indicated for the treatment of female adult and pediatric patients 12 years of age and older, weighing at least 40 kilograms (kg), with uncomplicated urinary tract infections (uUTIs) caused by the following susceptible microorganisms: Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii complex, Staphylococcus saprophyticus, and Enterococcus faecalis.

However, at Red Rock, we are recommending caution in its use, as the package insert notes that it prolongs the QT interval and has significant anticholinergic effects. We have requested more information from the manufacturer.

[KFF News – 5/19/2025]

Link to source

Not all Pharmacy medication dispensing cabinets are the same

At Red Rock Pharmacy, we prioritize regulatory compliance and patient safety in every aspect of our operations - including the use of medication dispensing cabinets like Cubex and Omnicell. These automated systems are effective for managing medication inventory in long-term care settings as nurses can quickly grab emergency medications rather than waiting for pharmacy deliveries. However, it can subject to another survey from State Board of Pharmacy if not managed carefully.

At Red Rock Pharmacy, we take a proactive approach to avoid these regulatory burdens. While we do provide Cubex machines, we intentionally stock them with fewer than 60 total medications and no more than 12 controlled substances. This allows our dispensing cabinets to be classified as an “emergency kit” rather than SPDOs, exempting our partner facilities from the SPDO licensing process and related inspections.

For example In Colorado, the State Board of Pharmacy defines a Specialized Prescription Drug Outlet (SPDO) as a medication storage site located in a long-term care facility (LTCF) or inpatient unit that contains more than 60 medications in total and more than 12 controlled substances. Meeting or exceeding these thresholds classifies the cabinet as an SPDO, triggering a set of state requirements—including a special registration, monthly inventory audits, annual surveys by the state board of pharmacy, recordkeeping of distribution, and many others (please refer to Colorado State Board of Pharmacy chapter 25.00.00 for complete list of requirements). 

We encourage all facilities to be cautious of other LTC pharmacies offering SPDO-level machines. While these may offer broader access to medications, they come with significant state-regulated responsibilities, including licensing, maintenance protocols, and oversight that may not be feasible or desirable for every facility.

By following state regulations and keeping quantities below the SPDO threshold, Red Rock Pharmacy helps LTC partners stay compliant and survey-ready, while still ensuring residents have timely access to essential medications.

Stacey Chang

Pharmacist In Charge

Denver Colorado

Should Everyone Be Taking Ozempic? 

That’s the provocative question recently posed—half-jokingly—by The Wall Street Journal.

As of now, about 8 million people in the U.S. are taking medications like Ozempic, though more than 130 million meet FDA indications for treatment. Barriers such as cost and the injectable format are limiting broader use.

A review article published May 25, 2025, highlights a wide range of conditions that may benefit from GLP-1 medications, possibly due to their anti-inflammatory effects. Reported benefits include:

• Psoriasis
• Osteoarthritis and Sleep Apnea (via weight loss)
• Fatty Liver Disease
• Alzheimer’s Disease

Ongoing studies aim to further clarify the potential role of GLP-1 medications like Ozempic—not only in diabetes and obesity but also across a broader spectrum of health conditions.

Read More

New blood test for Alzheimer’s Disease  (which may replace PET scans) approved

The FDA has cleared the first blood test to help diagnose Alzheimer’s disease—potentially reducing the need for costly PET scans.

The newly approved Lumipulse G pTau217/ß-Amyloid 1-42 Plasma Ratio (yes, that’s a mouthful!) detects the presence of amyloid plaques in adults aged 55+ who show signs of Alzheimer’s.

The test measures two key proteins—pTau217 and β-amyloid 1-42—and calculates their ratio in the blood. This result closely correlates with the presence of amyloid plaques in the brain.

In a study of nearly 500 individuals:

• 91.7% of those who tested positive had confirmed amyloid plaques via PET scan or spinal fluid test
• 97.3% of those who tested negative were also negative on confirmatory testing

This is a promising step forward in earlier, less invasive Alzheimer’s detection.

👉 Read the full FDA announcement



New Update in the Management of Delirium

There was an update in delirium at the recent 2025 American Psychiatric Association Annual Meeting in Los Angeles, California, where it was reported that about 40% of delirium cases are preventable. The American Psychiatric Association has updated its guidelines for the management of delirium for the first time since 1999.

The new emphasis is on prevention, which is the main difference from the previous guidelines, along with no longer advising against the use of antipsychotics such as Haldol or the newer atypicals.

Furthermore, the suggested use of benzodiazepines is now limited to alcohol withdrawal delirium with catatonic features or delirium with catatonia. There are situations where removing a benzodiazepine could cause more harm than good—such as in individuals with panic disorders.

Read the full article here

RSV Update – Part 2

A large-scale study published in JAMA confirms that RSV vaccines offer strong protection for adults 60 and older, reducing RSV-related respiratory illness by approximately 75%.

The analysis, which reviewed data from over 787,000 older adults tested for RSV between October 2023 and April 2024, found that the vaccine’s effectiveness was consistent across age groups 60–74 and 75+. It also helped reduce emergency department visits and hospitalizations at comparable rates.

These findings strengthen the case for prioritizing RSV vaccination in older adults to prevent severe outcomes.



Read more