Pain management question

[npage148]

So maybe someone more well versed can help me out. A paitient in his 20's is maintained on 60mg oxycodone a day in divided doses for "opiate management". He has dental surgery and is given Norco 10mg q6h for pain. He states the doctor giving him the oxy is ok with the norco and he also claims he can't take more oxy because he'll run out early so he needs the Norco. So, will 10mg of hydrocodone be effective to manage his pain? In my mind it's a stupid way to manage pain. Putting a low dose weak opiate on top of pretty legit doses of oxy

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[gtpederson]

Sounds bogus.
60mg of oxy is going to be covering up any dental pain more than any Norco 10s.

 

[All4MyDaughter]

So maybe someone more well versed can help me out. A paitient in his 20's is maintained on 60mg oxycodone a day in divided doses for "opiate management". He has dental surgery and is given Norco 10mg q6h for pain. He states the doctor giving him the oxy is ok with the norco and he also claims he can't take more oxy because he'll run out early so he needs the Norco. So, will 10mg of hydrocodone be effective to manage his pain? In my mind it's a stupid way to manage pain. Putting a low dose weak opiate on top of pretty legit doses of oxy

I would call the pain management doctor to verify. The patient may have an opioid agreement that addresses whether this is ok or not.

 

[npage148]

I felt it was bogus and/or pain mismanagement by the dental clinic. He happened to bring it in the evening and I told him I would call the pain doc tomorrow before I'd fill it. He didn't like that and would just take it to a pharmacy closer to his home so I'll never get the resolution I desired

 

[All4MyDaughter]

I felt it was bogus and/or pain mismanagement by the dental clinic. He happened to bring it in the evening and I told him I would call the pain doc tomorrow before I'd fill it. He didn't like that and would just take it to a pharmacy closer to his home so I'll never get the resolution I desired

Yeah, I'm going to say he DEFINITELY has an opioid agreement and isn't supposed to be getting them from anyone but his pain management doc.

 

[MindOverMatter]

It's bogus. Like the earlier replier stated, the oxycodone will cover any dental pain incurred in the procedure.

This is like the people I get multiple times a day that have filled #210 oxycodone 30mg a week ago and now are dropping off Percocet 10/325s #180 because "this is for my ankle, the other stuff is for my back."

I'd auto-call his pain management doc to alert him of the potential breach of pain management contract.

 

[npage148]

Yep, stuff like that drives me crazy and is a total waste of time. 2+ doctor calls (who don't care 1/3 of the time) and a pissed off patient.

He's not a regular so I'm over it. Plus I ended up markin the script up so he'll never be able to get it filled without issues. The dentist wrote Norco solution (??) so i called the clinic to get it switched to lortab liquid. Pt didn't like the idea of that because "he's sensitive to apap" so got it switched to Norco tab. AND then the DUR with oxy pops when I finally get around to processing it. Ugh.

 

[zelman]

Yep, stuff like that drives me crazy and is a total waste of time. 2+ doctor calls (who don't care 1/3 of the time) and a pissed off patient.

He's not a regular so I'm over it. Plus I ended up markin the script up so he'll never be able to get it filled without issues. The dentist wrote Norco solution (??) so i called the clinic to get it switched to lortab liquid. Pt didn't like the idea of that because "he's sensitive to apap" so got it switched to Norco tab. AND then the DUR with oxy pops when I finally get around to processing it. Ugh.

Sensitive to APAP? 99.9% of the time = inappropriate drug seeking