Super tolerant opiod pts

[museabuse]

What is the most narcotics u have ever dispensed? I was at a pharmacy and dispensed to regular, oxydose 20mg/ml #840. 6ml 5xday. And fentanyl 100mcg/hr #45 3 q48.

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[Pharmavixen]

Methadone 840 mg daily. Pt was also on Clonazepam 12 mg daily (4 mg tid), Risperidone 8 mg daily.

One of my methadone patients, on 200 mg daily, told me confidentially he'd bought a 75mg fentanyl patch on the street and ate it on a day his back pain was especially bad (he'd become addicted to heroin after suffering a serious industrial accident about 20 years ago). I said, "Joe -- people have died doing that." He nodded thoughtfully before replying, "Yes...it was very good."

 

[Jeddevil]

Oxycontin 80 - 9 bid #540. This guy (cancer pt) was on oxy ir also, but I don't remember what it was. I looked through his profile and he was gradually going higher every qtr or so, starting out on a ton of 40mg's, then moving up to 240 80's, 360 80's, etc. I do remember he dropped it off in the drive-thru, which I found a bit funny. Best part for him - brand oxy, $0 co-pay.

 

[pharmdawg000]

2 grams morphine/day

 

[Old Timer]

MS-Contin 1800 mg every 12 hours. When I called the doctor at the local cancer hospital he informed me the patient was a heroin addict who had pancreatic cancer with bone mets and he had an extremely high tolerance for opiates.....

 

[Omegadramon]

Every post in this topic has made me yell "FFFFFFFFFFFFFFFFFF---"

these are unbelievable doses...

 

[BravoKilo]

Ran across this post on the Pharmacist's Letter a while back -- still amazes me...

I remember a terminally ill cancer patient in December 1999 who was on a hydromorphone PCA. This patient was using so much that we had to order hydromorphone power and compoud the PCA from it. Here's the amount:

250 mg/hour + 10 mg bolus prn(q 10-60 min? I did not make a note of that)

So if you "convert" to IV morphine that is about ~39,999 mg/day morphine not counting any bolus.
And that "converts" to ~119,997 mg/day oral morphine.

And that "converts" to ~79,998 mg/day oral oxycodone. Not sure how long he was on this.

 

[Storm90]

Methadone 280mg qd, Fentanyl patch 800mcg q48h, Morphine 2g/day infusion, hydromorphone 1600mg/day infusion. I also had a lady on Lorazepam 20mg BID. She was always snowed.