“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
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
Question for practicing pharmacists on therapeutic duplication
hello folks!
I got an rx for aspirin 81 mg and aspirin 325 mg 1 t po prn from the same dr. One would be for cardioprotection and the other most likely for pain? It seemed odd to me bc I’ve never really seen both, so I wasn’t sure what to do. As per lexicomp, aspirin can be used 325-650 mg
Po q4-6 like acetaminophen, and has a daily max of 4g.... so technically it would be ok to dispense both the 325 and 81 mg without calling or clarifying? The doctor never returned my call nor picked up....
Question for practicing pharmacists on therapeutic duplication (Source: Student Doctor Network)
Source: Student Doctor Network - February 12, 2018 Category: Universities & Medical Training Authors: MARX22 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
Multimodal anesthesia
Have you all been using multimodal anesthesia? If so, what? My current choices are listed below.
In pre-op holding:
Acetaminophen 975 mg PO
Celebrex 400 mg PO
Gabapentin 600 mg PO
At the start of anesthesia:
50 mg/kg MgSO4 IV
On certain cases I will add 10 mg dexamethasone to the bupivacaine for the local.
Patients complained about nausea when I've used OxyContin pre-op so I stopped.
I think what's made the most noticeable drop in post-op pain...
Multimodal anesthesia (Source: Student Doctor Network)
Source: Student Doctor Network - December 15, 2017 Category: Universities & Medical Training Authors: NatCh 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
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
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 13, 2016 Category: Universities & Medical Training Authors: Albo Source Type: forums
