What would you do first prior to prescribing any medication
What would you do first prior to prescribing any medication
Due to Howard’s statements, I believe a urine drug test is required prior to treatment of Rx opioids. The CDC has developed a guideline with 12 recommendations for prescribing opioids for chronic pain. These guidelines address initiation or continuation of opioids for chronic pain; selection of opioid medication including dosage, duration, follow-up, and discontinuation; assessing risk; and addressing harmful use (Woo et al., 2020).
2. What are the various schedules of medications for controlled substances?
Drugs, substances, and certain chemicals used to make drugs are classified into five (5) distinct categories or schedules depending upon the drug’s acceptable medical use and the drug’s abuse or dependency potential.
Schedule I: Substances or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Examples heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote.
Schedule II: Substances or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Examples: Combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin.
Schedue III: Substances or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Examples: Products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone.
Schedule IV: Substances or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Examples: Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol.
Schedule V: Substances or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Examples: cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin (DEA, 2020)
3. Would you prescribe a long or short acting narcotic? Why or why not?
According to the CDC guidelines in regard to Rx opioids, I would start with Acetaminophen and a Muscle relaxant for this patient. Nonopioid analgesic options recommended include acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), anticonvulsants such as gabapentin and pregabalin, and limited use of baclofen or tizanidine (Woo et al., 2020).
Discussion 2
1. What other non narcotic medication options can you offer to this patient?
Acetaminophen or Muscle relaxants like Baclofen and an SSRI like Zoloft. Muscle relaxants can be used for short term use according to the CDC guidelines. Nonopioid analgesic options recommended include acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), anticonvulsants such as gabapentin and pregabalin, and limited use of baclofen or tizanidine (Woo et al., 2020).
2. What patient education is needed with them?
Education on addiction and reasons why opioid use is limited and monitored by the DEA/federal government. opioid epidemic. Use of natural and synthetic, illicit and prescribed opioids has been increasing. In 2016, 11.8 million people age 12 and older in the United States misused prescription opioids, and 948,000 used heroin (Woo et al., 2020). Mortality has also increased as a result of this recent surge in use. Guideline 8: Before starting and periodically during continuation of opioid therapy, clinicians should evaluate risk factors for opioid-related harms (Woo et al., 2020).
3. What would you do if the patient and his wife tell you that none of them work for him?
As a NP I would further educate the patient and caregiver on the definition of “works”, Education on opioid use, tolerance and dependence, there are times when a patient’s pain does not subside and that may be the patients baseline. As providers we are to attempt to get pain to a tolerable level but diminishing pain may be unrealistic and education on this is just as important. The NP should also assess patient for drug use and order a drug test before any opioids are Rx.
Reference:
Drug scheduling. DEA. (2020). Retrieved October 21, 2021, from https://www.dea.gov/drug-information/drug-scheduling.
"You need a similar assignment done from scratch? Our qualified writers will help you with a guaranteed AI-free & plagiarism-free A+ quality paper, Confidentiality, Timely delivery & Livechat/phone Support.
Discount Code: CIPD30
WHATSAPP CHAT: +1 (781) 253-4162
Click ORDER NOW..
