DOI: 8/31/1999. Patient is a 54-year-old female operator who sustained a work-related injury to her knee after tripping over a box. She is status post seven right knee surgeries. Urine drug screen dated 12/11/2014 showed positive findings for hydrocodone and hydromorphone.
Based on the medical report dated 10/27/16, the patient rates her pain with medications as 4/10. Her activity level has increased.
Current medications include Voltaren 1% gel to be applied 2-3x/day to the affected area, Evzio 0.4 mg auto-injector, Norco 10/325 mg 1 tablet every 4-6 hours as needed with maximum of 5 per day, trazodone 100 mg, atorvastatin, omeprazole, Proair “Hfa”, Symbicort, Flexeril 10 mg and trazodone 100 mg.
Of note, urine drug screen dated 05/19/16
1000 Pt denied pain at this time and rate 0 on a scale of 0 to 10. Pt thanks me a lot for pain medication I gave her. Instruct the pt to report her pain early before it get worse so I can give pain medication. Pt verbalized understanding of the teaching. No sign of distress or discomfort at this time. Will continue to monitor………L.Gotora
Williams, the patient reports occasional low back pain that he rates from 0-3/10. On this visit, he has no low back pain.
The patient was advised to take less medication and start weaning herself off of it as possible, and this is all in due to protect her kidneys and liver function and also a second prescription was given for Norco 10/325 one tablet twice daily #60 with "Do Not Refill or Do Not Dispensed Until 11/06/2016. The patient is to continue going to the gym and working on her stretching and strengthening exercises. Acupuncture 2 visits a week for 4 weeks for a total of 8 visits for her right shoulder is also requested, since she is starting to get more pain and this is limiting her activity such as vacuuming, and she is taking more medications because of increased pain. POMI (Patient Opioid Misuse Index) score shows 1/6, indicating the patient is not a potential misuser of
At today's visit, she is accompanied by her husband. She is awake, alert and oriented. She complains of chronic, dull, intermittent, burning pain in her thighs which radiates down her legs. She rates her pain as a 3/10. She states that taking the
Per medical report dated 03/17/16, patient’s medications are chlordiazepoxide 10 mg, Butrans 10 mcg, Fentanyl 75 mcg, Norco 10 mg/325 mg, venlafaxine ER 75 mg, Ambien CR 12.5 mg, Cymbalta 60 mg, Capsaicin Hot Patches 0.025% Ext Pads, terazosin, Levothyroid 125 mcg and Androgel pump 1%.
Based on the progress report dated 09/12/16, the patient reports more frequent pain with activity since the last
On Primary Treating Physician’s Progress Report (PR-2) dated 08/11/2017, the patient presented with unchanged symptoms. His left-hand pain was rated at 8/10. and was described as constant and sharp. The pain was aggravated with certain movements and gripping. The
Citalopram HBR 20mg (1x daily), Clonazipam 2mg (1x daily), albuterol (as needed), Ventolin (as needed), ondonsetronorally disintegrating tablet 8mg (as needed), ibuprofen 800mg ( as needed), Benadryl 25mg ( as needed) fluticasone propronate 50mg 1 daily.
) Discuss the public health impact of opioid misuse and abuse, including costs related to healthcare and criminal justice costs. Opioid drugs are valuable medications in treating acute and chronic pain that cannot be managed with nonopioid therapy, but inappropriate prescribing can cause serious harm. Taking higher doses or a combination of short-acting and long-acting opioids are likely to be abused and can also cause serious dose-related adverse effects that can include death. Opioid abuse affects the community and families in some way. It can lead missed work and sometimes it can be a problem keeping a job. Therefore, it is important that we obtain medication history to give us a picture of the patient pain medication history. While opioid
Per the Agreed Medical Re-Examination report dated 09/29/15, whole person impairment rating is 5%. Future medical care includes access to follow-up visits for monitoring of his condition for the next calendar year, with continued provision of pharmacological agents. Should patient experience a significant acute symptoms flare-up within the next calendar year, re-instatement of brief courses of traditional PT, acupuncture,
While narcotics are most commonly used to treat acute pain, opioids, one subgroup of narcotics, are being used most commonly to treat chronic pain. The number of opioid prescriptions has been on the rise over the past 25 years, increasing from “76 million prescriptions in 1991 to nearly 207 million in 2013” (Volkow, 2014, p. 1). This has no doubt contributed to the increasing number of unintentional overdose deaths seen in recent years. The United States has seen their unintentional overdose rates quadruple since 1999, which may be explained by the fact that the United States is responsible for the use of nearly all of the word’s hydrocodone (Volkow, 2014).
Many addictions to these opiates are caused by inaccurate treatment of pain by the patient’s doctors. According to Andrea M. Garcia, “Treatment of pain is inadequate due to uncertain diagnoses, societal stigma, the lack of effective treatments, and inadequate patient and clinician knowledge about the best ways to manage pain. Prescription painkiller overdose has reached epidemic proportions over the past decade.” When patients visit a doctor’s office due to pain, they often do not elaborate on the pain they feel or give accurate diagnosis of the pain they are experiencing. Patients will often over exaggerate their pain level in order to be prescribed higher doses of narcotics. Shoulder or knee pain is a very common complaint. Patients who
Hydrocodone a drug used to change how your brain and your nervous system reacts to pain. When taken the medication correctly it should relieve mood, reduction of pain. Hydrocodone was introduced in the 1920’s from the country of Germany. Carl Mannich and Helenen Lowenheim were the first to report it being in use in 1923( Eckenrode, S. L. (2015).Hydrocodone is a form of opiate, analgesic, it is described as white crystals as a crystalline powder and reacts to light. This drug classified as a schedule II drug known as a controlled substance. Hydrocodone is often always found in combination with acetaminophen such as Vicodin and Lortab (Advokat, C. D., Comaty, J. E., & Julien, R. M. 2014). As of 2012, the United States Hydrocodone is the most used drug prescribed to treat pain. The United States has consumed 99% of this global supply for 4.4% of the worldwide population. (Manchikanti, L., Atluri, S., Kaye, A.M., Kaye, A.D). The US Drug and food administration approved the drug for sale in the United States in 1943.
Oxycodone is an opioid pain medication. An opioid is sometimes called a narcotic. Acetaminophen is a less potent pain reliever that increases the effects of oxycodone.
In the United States, the number one prescribed medication in physician office visits, hospital outpatient visits, and hospital emergency departments visits are analgesic medications. Some of these visits are in regards to extended pain management with opiate drugs. Hydrocodone is one of the most common medications prescribed for pain control after the use of non-opioid medication treatment failed (CDC, 2014). On October 25, 2013, a new form of hydrocodone was approved by the United States Food and Drug Administration, Zohydro ER, an opioid agonist. This new drug became commercially available with a physician’s prescription in March 2014 and is to be prescribed for chronic or severe around the clock pain for users with long