Shingrix: Key differences from Zostavax that you should know

By holladay | January 15, 2019 | 0 Comments

Shingrix is the new shingles vaccine on the block; and it has led to some confusion among healthcare providers.  This has led to a number of reported medication errors via the Vaccine Adverse Event Reporting System (VAERS).  Errors have included incorrect storage, wrong route of administration, and incorrect reconstitution. 

There are some key differences to make note of between Shingrix and the older Zostavax vaccine. First and foremost, Shingrix is not a live vaccine (Zostavax is live).  Shingrix is supplied as a 2-vial set containing 1 vial of lyophilized varicella zoster virus glycoprotein E antigen and a single dose vial of AS01B adjuvant suspension.  The antigen component must be reconstituted with the adjuvant suspension.  While the Zostavax virus was to be stored frozen, the new Shingrix vaccine is stored refrigerated between 36-46 F. 

Also, the route of administration differs in that Shingrix is given as an intramuscular injection while Zostavax is subcutaneous. Shingrix is given in 2 separate doses. The second dose is administered 2-6 months after the first dose. Shingrix is also now the preferred vaccine to prevent herpes zoster. 

Please contact Holladay Pharmacy at 1-800-848-3446 if you have questions regarding this new vaccine.  

Celebrating 10 Years of Educating the Long Term Care Community

By holladay | December 17, 2018 | 0 Comments
By: Becky Cross, RN, BSN
Holladay Director of Customer Relations and Nurse Consultant
Holladay Healthcare Pharmacy will be hosting our 10th Annual Holladay Educational Learning Program (H.E.L.P.) on March 21st & 22nd, 2019.  The program will be held at the Proximity Hotel in Greensboro, NC.  H.E.L.P. offers attendees the flexibility to attend either 1-day or both days of the conference, with CE Hours being offered to both Administrators and Nurses. Register early as H.E.L.P. sells out every year!   Please visit our website –, starting in January for more information about the conference, including the agenda and registration details.  The conference offers pertinent LTC topics, an outstanding venue and excellent networking opportunities. See you at H.E.L.P. 2019!

CDC Gives Thumbs Up to SHINGRIX

By holladay | October 15, 2018 | 0 Comments

According to the Centers for Disease Control (CDC) website (accessed 9/6/2018) almost 1 out of every 3 people in the US
will develop shingles in their lifetime. The risk of shingles increases with age.
Shingles causes a painful rash or blisters that usually resolve in 2 to 4 weeks, but can also cause a
complication called post-herpetic neuralgia which is nerve pain in the area where the rash was located that
can last for months or years and be severe and debilitating.
A shingles vaccine known as Zostavax has been in use since 2006, but in 2017 the FDA approved a new
vaccine called Shingrix which is > 90% effective in preventing shingles and nerve pain in people 50 years
old and older, and is now the CDC preferred vaccine to prevent shingles. The CDC recommends that
healthy adults 50 years old and older get 2 doses of Shingrix 2 to 6 months apart, including those who
have had shingles in the past and those who previously received Zostavax at least 8 weeks prior.
Shingrix is now covered by many health insurance plans. If you have questions about shingles vaccine
feel free to contact your Holladay Healthcare Pharmacy pharmacist at (800) 848-3446.

Article by: Charlotte Matheny, PharmD, BCGP


By holladay | January 18, 2018 | 0 Comments
There has been extensive evidence to support using proton pump inhibitors (PPIs) for short term use only. Unfortunately, in the long term care setting, most patients take PPIs due to being discharged on one from the hospital. Part of the job of the pharmacist consultant is to keep patients safe and this includes requesting that PPIs like Prilosec and Protonix are used for the shortest duration possible when appropriate.
The evidence supporting adverse events such as increased risk of infections from Clostridium difficile, increased events of osteoporosis, electrolyte imbalances and B12 deficiency has brought this class of medication to be on the BEERS list, or the list of medications that are potentially inappropriate for use in the elderly. Recently a new adverse event was identified.
Recent investigations have suggested an association between PPI use and an increased risk of dementia. While the increase was seen in all types of dementia, Alzheimer’s disease was specifically identified. Several studies have been conducted to try and find the cause.
Gomm et al, provided evidence of a link between PPI use and dementia.1 The study looked at over 70,000 participants over 75 years of age and who were free of dementia. The participants were followed for 7 years and were divided into 2 groups; those who took PPIs and those who did not.
After adjusting for other risk factors, the PPI users were found to be 44% more likely to be diagnosed with dementia. While an absolute causation has not been established, best practice would be to minimize the use of the PPI class of medications in the elderly.
1. Gomm W, Klaus von H, Friederike T et al. Association of proton pump inhibitors with risk of dementia: a pharmacoepidemiological claims analysis. JAMA Neurol 2016;73:410-6.
Christy Ledger, PharmD, MS, BCGP, is a consultant pharmacist with Holladay Healthcare Pharmacy. 

How to Help Save Lives with Med Reminder Apps

By holladay | August 26, 2016 | 0 Comments

Medication non-adherence can be a life-threatening prospect for some long term care facility residents. Nearly 125,000 deaths annually are attributed to failed medication adherence. It can also be a costly problem within your facility. When residents who are on strict or complex medication regimens get off schedule or take the wrong dosage, the result is typically repeated hospitalizations. As they return to your facility, additional time and attention is also required from your staff to properly monitor those residents. Most people don’t intentionally skip a dose or get their pills mixed up, but, sometimes, they just get confused or forget. The good news is that there are many med reminder apps available for those residents who regularly use a smartphone or mobile device.

 So, how do you choose one?

Last year, the University of Arkansas conducted a study of 461 medication adherence apps and presented their findings at the American Pharmacist Association annual meeting. This shows us two things. First, a mobile app is now a viable alternative to pill cases and sorters that really only help organize medications. Second, the number of medication tracking apps is incredible. Here are the three top performers. Each application was rated on a scale of 1-5 stars (5 being the best) across five categories: Adherence Attributes, Medication Management, Connectivity, General Features, and Health Literacy.


Overall Rating:  5 stars

To make managing meds easier, Medisafe enlists the help of visuals. The app actually shows an image of every pill once each medication is entered, creating what the app creators refer to as a “virtual pillbox.” Medisafe received an overall rating of five stars with slightly lower marks in the Medication Management and Connectivity categories.

Key features:

  • Intuitive visual interface with easy-to-use medication reminder
  • Syncing family members’ devices and medications in real time
  • Prescription refill reminders
  • Medication progress reports that can be sent to a doctor or nurse
  • Reminders come through even if the mobile device is asleep
  • Notifications to designated contacts if the main user has forgotten to take medication or has ignored a reminder


Overall Rating:  5 stars

Sporting a clean and simple user interface, MyMeds touts the ease of managing medications. It also received an overall five-star rating, but received four stars in the Adherence Attributes and General Features categories.

Key features:

  • Daily medication and refill reminders via text, email or push notification
  • Clear information for helping users understand why to take their meds
  • Analysis of medication usage history
  • Price shopping of prescriptions near the user
  • Syncing with a healthcare team and loved ones


Overall Rating:  5 stars

Promoted as a mobile health manager, Care4Today has a broader focus beyond just managing medication schedules. It achieved an overall rating of five stars but fell short in the Connectivity and General Features categories.

Key features:

  • Notifications to help stay on schedule, including dosages
  • Reminders for prescription refills
  • Front and back stock images of the medications to be taken
  • Built-in reports that track medication consumption

Each of these med reminder apps is available for free on the App Store (i0S) and Google Play (Android). Residents who are able should consider downloading the best medication reminder app for their individual needs. This will ensure they’re taking the proper medications, in the right dosage, at the right time. They’ll be healthier in the long run and it might just save their life. For long term care administrators, financial and staffing resources will be better allocated toward providing the best proactive resident care possible.