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