Chronic pain
90 year old patient with chronic low back (prior lami/fusion) and continued knee pain after TKA. I’m the 3rd PM doc she’s seen. She failed to follow up with the other PM bc she says nothing was helping. per chart review she’s been tried on multiple meds(meds all with side effects or no relief: gaba, Lyrica, cymbalta, savella, Tylenol #3, Vicodin, oxycodone) I’m hesitant to try TCA at her age and she has afibb. I tried her on Butrans but didn’t help. Compound cream slightly helpful. Starting... Chronic pain (Source: Student Doctor Network)
Source: Student Doctor Network - April 28, 2019 Category: Universities & Medical Training Authors: Bsb2015 Tags: Pain Medicine Source Type: forums

31yo Stg IV Lymphoma Pt with h/o opioid abuse and psych history
Was on opioids previously for various pains, but became addicted and overtook and used her friend's pills etc H/o ER admission for suicidality, withdrawl, etc. Coming to see me monday Currently on Norco 5's 2 tablets every 4 hours for what she describes as diffuse bony pain. PET scan shows lypmh nodes lighting up in the neck/mediastinum/groin On high dose chemo and going to undergo bone marrow transplant after it. What would you do? Appreciate in advance any advice in this delicate... 31yo Stg IV Lymphoma Pt with h/o opioid abuse and psych history (Source: Student Doctor Network)
Source: Student Doctor Network - April 20, 2018 Category: Universities & Medical Training Authors: Timeoutofmind Source Type: forums

“I only want the norco, not the antibiotic”
Today a patient without insurance brought in two separate scripts, one for norco one for antibiotic. After finding out the antibiotic is over 50 dollars, he said he only wanted norco. I told him that we had to fill both, and he replied what if I never showed you the antibiotic? Then he left, likely to another pharmacy to show them just the norco. This got me thinking, how do you prevent patients from skipping out on antibiotics? (Source: Student Doctor Network)
Source: Student Doctor Network - March 26, 2018 Category: Universities & Medical Training Authors: a student Source Type: forums

New abuse resistant hydrocodone (Adapaz) approved by FDA
The FDA just approved a hydrocodone prodrug that cant be snorted/injected/smoked. If they try it's inactive in the blood stream. It needs to be activated by stomach enzymes. I think this is going to be huge, especially if they allow it to be dispensed as a c3 instead of a C2. (Source: Student Doctor Network)
Source: Student Doctor Network - March 3, 2018 Category: Universities & Medical Training Authors: RiteAidRockStar Source Type: forums

Exam 1: Hostile Medicaid Alcoholic Wants Vicodin; hates Tramadol
View attachment 229887 Exam concordant for facet mediated pain. Brethalyzer and urine negative for ETOH. No procedures covered by state Medicaid & can't afford cash price. Reached cap for PT. Said acupuncture was "pure BS" and refuses to chiro because "they're all quacks and paralyzed my uncle." What's your next move? (Source: Student Doctor Network)
Source: Student Doctor Network - February 27, 2018 Category: Universities & Medical Training Authors: drusso Source Type: forums

Post surgical pain treatment in Germany
Nice article on how they treated this woman post surgically without Narcotics. Wouldn't fly here in Amerrrca!! Opinion | After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea (Source: Student Doctor Network)
Source: Student Doctor Network - January 29, 2018 Category: Universities & Medical Training Authors: chocomorsel Source Type: forums

CII script change
Hey everybody, Im pretty new to this and am a recent pharmacy grad. I currently am a floater for a chain and I had a question for a CII I filled my first week of practicing that I still debate was the right move or not. So I got a script for norco from a usual patient of the pharmacy it was for norco 10/325, 1 po q 8 hrs prn pain #270 90 day supply, and the patient said she its suppose to be 1 po q6 #360 as what she normally was getting, which was accurate upon checking her profile. So I... CII script change (Source: Student Doctor Network)
Source: Student Doctor Network - January 9, 2018 Category: Universities & Medical Training Authors: pharmacisttotherescue Source Type: forums

Exam room #2: Medicaid, Fibro, FBSS, failed SCS, 40 mg of hydrocodone
What's your next move? View attachment 226936 (Source: Student Doctor Network)
Source: Student Doctor Network - December 22, 2017 Category: Universities & Medical Training Authors: drusso Source Type: forums

What are your thoughts on opioid prescriptions for kids/adolsecents?
I am just wondering what are your thoughts and experience with seeing these type of prescriptions? As long as the dose matches up with the dosing regiment on say lexicomp, do you question the dose any further? Any particular drugs you deny, besides say codeine/tramadol formulations? One last question to add, I have looked this up and it seems to be the norm, but i am just wondering to be sure. Have you all seen Percocet/Norco while breast feeding, especially after say c-section or after... What are your thoughts on opioid prescriptions for kids/adolsecents? (Source: Student Doctor Network)
Source: Student Doctor Network - December 12, 2017 Category: Universities & Medical Training Authors: nsansom15 Source Type: forums

What would you do?
If you are a floater and get a script for norco, xanax, and soma, you see it’s been filled before. Would you fill it? You don’t want to lose a customer but you also don’t want to hurt the patient or get in trouble (Source: Student Doctor Network)
Source: Student Doctor Network - December 9, 2017 Category: Universities & Medical Training Authors: PharmProfit Source Type: forums

Nucynta
inherited a patient on nucynta..100mg ER q12h and IR100mg q12h for breakthrough. Continued it last visit as it is helpful for him. Been on it for a year. Now patient says it's too expensive for him, how would transition him? Slow taper off and add tramadol at the same time? I don't want to escalate to norco or other narcotic, but if I did, what is the equivalent? Couldn't find much online about it Thanks in advance (Source: Student Doctor Network)
Source: Student Doctor Network - September 7, 2017 Category: Universities & Medical Training Authors: painfree23 Source Type: forums

Control early refill?
Would you fill controlled substance rx 30 days supply, 8 days early if it goes through insurance? I am not comfortable if a patient keeps filling CS early where they can stock pile meds... I had customers pretty much scream and yelled at me because I would not fill if it is way too early, I told them 2-3 days early is ok... California Say Vicodin #180 tabs/30 days, 8 days early (48 tab extra/month) (Source: Student Doctor Network)
Source: Student Doctor Network - August 14, 2017 Category: Universities & Medical Training Authors: Momus Source Type: forums

Would you fill these rxs?
Hi everyone, Would you question/fill these rxs? Scenario 1: Only medications on file are ambien cr 12.5 mg (#90), norco 10 mg (#180) and soma 350 mg (#120). They are all written by the same doctor. Scenario 2: Is prescribed soma 250mg and oxycodone 15 mg (#120) from the same doctor, who is a visiting physician (i.e sees patients at their homes.) Scenario 3: Fills methadone 10 mg (#320)- prn dosing and klonopin 1 mg monthly. They're both written by the same doctor, an internist. (Source: Student Doctor Network)
Source: Student Doctor Network - July 25, 2017 Category: Universities & Medical Training Authors: mimi06bg Source Type: forums

Methadone & Norco 4 neuropathy?
Has anyone seen methadone and Norco by the same doctor for peripheral neuropathy? Would you fill that? (Source: Student Doctor Network)
Source: Student Doctor Network - July 4, 2017 Category: Universities & Medical Training Authors: Mambo#5 Source Type: forums

Would you fill this C-II Rx?
Received a Rx for Lortab 7.5/325/15ml . Would you fill this Rx? I refused to fill it as in my pharmacy system only recognize Hycet 7.5/325/15ml but for Lortab was 7.5/500/15ml, now is 10/300 I believe... however, If I direct type in generic as hydro/APAP 7.5/325/15ml , will consider " changed name of the medication" ??? I talked to the Dr. over the phone later, and He said he has been written the same drug in same way for many years, no one has refused to fill them...so am I over... Would you fill this C-II Rx? (Source: Student Doctor Network)
Source: Student Doctor Network - June 30, 2017 Category: Universities & Medical Training Authors: rx201605 Source Type: forums

DC MPJE Exam
Passed D.C. MPJE on second attempt. First time I studied all the handouts from the website (not recommended) Know the Guide to Federal Pharmacy Law by Reiss like the back of your hand. I literally read EVERY page and answered every single practice question. Read DEA Pharmacist Manual. It's from 2010, so make sure to know all Hydrocodone is now CII. Otherwise, the D.C. stuff from the website to know, prescription records must be kept 5 years, CII scripts only good for 30 days. Like know... DC MPJE Exam (Source: Student Doctor Network)
Source: Student Doctor Network - May 10, 2017 Category: Universities & Medical Training Authors: RxDoc331 Source Type: forums

Doctor removed from United Airlines had opioid RX'ing issues
http://www.state.ky.us/agencies/kbml/finalorders/22439.pdf http://nypost.com/2017/04/11/doctor-dragged-off-flight-convicted-of-trading-drugs-for-sex/ "Dao’s own medical license was suspended in 2003 following his arrest on charges including unlawful prescribing and trafficking in a controlled substance. He was accused of providing prescriptions for Vicodin and other narcotics to a former patient he later hired as his office manger, who was identified in news... Doctor removed from United Airlines had opioid RX'ing issues (Source: Student Doctor Network)
Source: Student Doctor Network - April 14, 2017 Category: Universities & Medical Training Authors: drusso Source Type: forums

PHN refractory to conventional treatment
I saw a new patient in the office yesterday. 70 y/0 M with 1.5 years of severe pain secondary to a shingles outbreak in the left T5/T6 dermatomes. It doesn't appear that he received timely antiviral therapy at the time of outbreak and now he is suffering for it. He even asked to take off his shirt during the middle of the consultation secondary to pain. Prior to seeing me he has tried Hydrocodone, Gabapentin, Lyrica, Amitriptyline, Lidocaine ointment / patches, Calamine lotion and... PHN refractory to conventional treatment (Source: Student Doctor Network)
Source: Student Doctor Network - March 30, 2017 Category: Universities & Medical Training Authors: EruditeDoc Source Type: forums

Upcoming Knee Surgery.
Im new to the forum so if I'm posting this in the wrong section I apologize. I am 26 years old and I am going in for my second knee surgery due to multiple patella dislocations. My first surgery was similar to a lateral release. Now my surgeon is going to try something more extensive. My question is after my first surgery I was given hydrocodone 10mg/325, which didn't do a whole lot. Now right now before my surgery my surgeon prescribed me percocet 5/325, which doesn't do anything, I have to... Upcoming Knee Surgery. (Source: Student Doctor Network)
Source: Student Doctor Network - February 11, 2017 Category: Universities & Medical Training Authors: Skinnybandit Source Type: forums

Prescribing Tramadol and Norco together!
Just wanted to know you guys thought on this increased habit of physicians prescribing Tramadol and Norco together. I see this more and more often and technically being both short acting pain medications that work by similar mechanism it is not a proper treatment for pain. I don't think it was this bad when tramadol was a non controlled but since it became controlled doctors for some reason keep overprescribing it with other short acting pain stuff. Would you fill Tramadol and Norco together? (Source: Student Doctor Network)
Source: Student Doctor Network - September 14, 2016 Category: Universities & Medical Training Authors: Albo Source Type: forums

Doctor's self Rx. your state's policy & your educated stance
So I am currently a resident physician and read an article discussing about self prescribing among residents. I was talking among colleagues and many of them admit to self prescribing or having a friend or wife/ husband write them an Rx. Several even admit to having prescribed class IV medications for themselves (valium, vicodin, ambien) were some of the examples. What is the teaching from your pharmacy school and what is your state pharmacy boards policy? On a personal note I have... Doctor's self Rx. your state's policy & your educated stance (Source: Student Doctor Network)
Source: Student Doctor Network - August 5, 2016 Category: Universities & Medical Training Authors: geldrop Source Type: forums

I'll take the norco but I don't want the antibiotic
Happens sometimes even when the antibiotic is like $2. Usually like a one week supply of norco out of an urgent care. Patient profile is littered with various pain meds throughout the last couple years. I see it happen kind of often with different people but it really pisses me off, have you ever straight up denied someone at the register over this kind of situation and returned the script? Or are they just too stupid to realize that the pain med does nothing to help an infection? (Source: Student Doctor Network)
Source: Student Doctor Network - July 18, 2016 Category: Universities & Medical Training Authors: ldiot Source Type: forums

Ways to be 100% sure that a controlled substance prescription is legitimate?
I have 3 different scenarios: Patient A has been getting hydrocodone/apap 10-325mg #150, phentermine 37.5 mg #30, promethazine /codeine syrup 473 ml, and Soma 350mg #90 every single month, with a diagnosis of "chronic pain and emphysema" for the past 3+ years, verified by her pain-clinic doctor, who writes all four scripts for her every month. She doesn't seem to have any symptoms of emphysema as her lung capacity is quite good when she shouted, screamed and threatened us for an entire 8... Ways to be 100% sure that a controlled substance prescription is legitimate? (Source: Student Doctor Network)
Source: Student Doctor Network - July 7, 2016 Category: Universities & Medical Training Authors: swatchgirl Source Type: forums

Help with a Little Conumdrum
Hey All, I am currently a floater at a retail chain where half of the stores I go to are OK and the other half are pretty rough. I would say that for the majority of the past 6 months I have been at the rougher stores (high medicaid population, high percentage of scripts are Norco/Perc's, extra DEA compliance). Currently there is an opening at a store that I believe is the least desirable store in the district (rougher store, 45 minutes away from my house, extended hours store, weak staff).... Help with a Little Conumdrum (Source: Student Doctor Network)
Source: Student Doctor Network - May 17, 2016 Category: Universities & Medical Training Authors: TLaw8860 Source Type: forums

Fake norco, anyone know how?
Just read this article on yahoo and a dozen people ingested fake norco. Anyone here know how to press the norco tablet or generic with the proper markings? I have made aspirin before but that did not have a good shape. This could be a good money maker to make some aspirin with the norco markings and do some street dealing. Pain will be covered for sure. Not sure about getting high though.... Fake norco, anyone know how? (Source: Student Doctor Network)
Source: Student Doctor Network - April 28, 2016 Category: Universities & Medical Training Authors: MrBonita Source Type: forums

What would you do?
I have a patient who came to me about a month ago as a consult. 65 female, right humerus displaced fracture, evaluated by ortho who recommended sling and non operative management. She fell because she was overtaking her opioids for FMS. On consult pain 10/10 and pt with severe anxiety restless. Arm has obvious deformity and massive bruising. They sent her home with some meds but she burned thru them too quick and was out; I don't remember but I think she was taking 8 norco per day. I... What would you do? (Source: Student Doctor Network)
Source: Student Doctor Network - April 15, 2016 Category: Universities & Medical Training Authors: SpineBound Source Type: forums

Chronic pain, opiates, and working?
I have a unique situation being that I'm 28 years old and suffering from chronic pain. I have confirmed bulging discs in my neck with bone spurs, degenerative disc disease, torn right hip labrum, post-op for left hip labral tear, and hypermobility syndrome. If you've never torn your hip labrum, it can be incredibly painful and disabling. It has made me couch-bound for the past few years. I could barely walk around to even do the household chores :( I've had two surgeries on my hips, and will be needing another one in a few months. I have been going through this for the past 4 years, so I'm hoping this is the last hip sur...
Source: Student Doctor Network Forums - February 9, 2013 Category: Universities & Medical Training Authors: chibipinkneko Tags: Pharmacy Source Type: forums

Alternative Pain Medicine
Hi all! I posted in the Adult Section just now - but wanted to post here as well. Looking for some alternatives to pain medicine - my BF is currently taking VICODIN (6-8 pills per day) to manage his chronic pain from CF and also to deal with the pain that comes with his recent lung surgery (left lung had collapsed recently) His current pain doctor feels that he is abusing the pain medicine, he is a 26 year old male (BF) Looking for some suggestions/help! We are in the process in looking for a new doctor for a second opinion but I would love to hear some alternative pain medicine that helps with the pain in the inner ...
Source: Cystic Fibrosis Alternative Medicine Forum - January 31, 2013 Category: Respiratory Medicine Authors: Nicole Emily Buckley Tags: Alternative Medicine Source Type: forums

can't log on to track
Forum: Applications and UCAS Posted By: Vicodin Post Time: 16-01-2013 at 23:01 (Source: The Student Room)
Source: The Student Room - January 17, 2013 Category: Universities & Medical Training Source Type: forums