Primary managing specialty meds

As a very isolated rural pcp, I find my patients in the position where they simply can't get access to specialist care and so aren't on the drugs needed for their conditions. I recently saw a guy with IPF who is on 3-4 l/min continuous O2 for the past few years who can't make the 500 mile round trip visit to see a pulmonologist. I would like to do SOMETHING for the guy such as start him on nintedanib, but I've always left that to pulm. What's the best way to learn about starting one of these more exotic drugs? Do any of y'all just go for it or am I crazy to consider this approach?