Patient Treatment Plan

On admission, he was taking 450mg/day of pregabalin to manage his neuropathic pain symptoms, and noted that it effectively reduced the sensations of numbness and burning within his neck, arms and legs, however he identified mild swelling in his extremities and weight gain as possible adverse effects from pregabalin treatment. With respect to the management of his headaches, nortriptyline therapy has decreased the frequency of his headaches from 5 to 2 episodes per week, but headache severity has remained unchanged, and typically rated at a 10/10. To treat the nociceptive and neuropathic pain, he is prescribed 90mg of duloxetine daily. He denies any history of depression or anxiety, however when asked about the drug’s effectiveness, he highlighted its positive effects on mood, noting that he is less emotional, less anxious and calmer since duloxetine therapy was initiated a year ago. These drug effects have allowed him to cope with the pain and stressful situations in his life more effectively. He notes that the immediate release morphine is not adequately controlling his breakthrough pain, and he also finds this medication to be constipating. He is uncertain whether Vimovo is providing him with any additional pain

At today's visit he is accompanied by his wife. He is awake, alert and oriented. He reports that his back pain has improved with the pain regimen he was started on last Friday. He complains of lower back pain that he describes as achy and constant; he rates his pain as a 7/10 in severity. He states that his pain doe not radiate, but it affects his mobility and impedes his ability to get out of bed by himself. His pain regimen is Morphine ER 15 mg p.o every 12 hours and oxycodone/apap 10/325 mg p.o every 4 hours as needed for breakthrough pain. He has taken 6 as needed breakthrough doses daily since Friday. He states that his pain has improved but his goal is to have his pain a little better than 7/10, then he will be able to perform his ADLS

Current medications include naproxen sodium, Prilosec, metformin, losartan, methotrexate sodium injection solution, folic acid, aspirin, Os-Cal 500 + 03 500 mg, metoprolol tartrate, Norvasc and Lyrica.

Pharmacist also looked at the current medication regimen and assess the appropriateness of such regimen and ask question such as, are her medical conditions optimally manage by pharmacological and nonpharmacological therapy. In light of her current condition, does the medication regimen need to be modify? Have the patient been concordance with the medication?

He was given a prescription for Norco 10/325 mg 1 tablet every 6 hours when necessary for pain, not to exceed more than 3 tablets per day. An interferential unit is requested for ongoing pain and discomfort in the lumbar spine.

To treat symptoms of insomnia or anxiety, she has had trials of lorazepam, clonazepam and temazepam, and in 2016, quetiapine in doses of 25-50mg per day was prescribed.

Zoloft is a common medication that is used for depression. Desai and Grossberg (2001) explain that Zoloft is an antidepressant medication and it helps balances mood swings and reduces anxiety (p.99). Researchers indicate an individual should present four out of the eight symptoms when being diagnosed with depression. Some of the symptoms include, trouble sleeping, agitated easily, not interested in activities, fatigue, loss of appetite, distracted, feeling guilty, and suicide attempt (Desai & Grossberg, 2001, p. 99). Researchers explain that dosages of Zoloft can range between 25mg to 200mg (p. 99). Prozac, Celexa, Lexapro, Cymbalta, Effexor, and Anafranil are medications that are also used to treat depression (Desai & Grossberg, 2001, p. 99). Nursing home residents with dementia tend to get anxious and nervous because they become forgetful and try to return to their previous living environment. Desai and Grossberg (2001) mention that Xanax is a tranquilizer and it is used to treat anxiety and panic disorders (p. 99). Some nursing home residents will start receiving higher doses and receiving more than one antipsychotic medications depending on their stage and symptoms. In this case, health professionals need to be educated on the different types of medications and their side effects to figure out the best treatment for their

Over the last few weeks we have rolled out several new protocols, if we can please take a moment to review our Narcotic prescription Drug Protocol.

DOI: 2/14/2011. The patient is a 52-year-old female clinical nurse who sustained a work-related injury to her low back from carrying a baby to the mother.

He was given a refill the prescription for Flexeril 10 mg #90 one tablet three times daily as needed, muscle relaxer with three refills and Motrin 800 mg #60 one tablet twice daily for inflammation with three refills.

Writer called Emory's pharmacy (270) 684-0649. Suboxone 8/2mg film 2.5 daily. Dispensed 20 for 8 days, no refills. Spoke to Bill

He was given a refill prescription for Butrans transdermal system extended release 5 mcg/hour #28.

Narcotic Drug Shortages - Morphine 2 mg injection and hydromorphone 2 mg injection are on allocation.

Calculating Dosages-Nurses with an order to "Give 750 mg every 4 hours as needed for pain" may receive 250 mg tablets from the pharmacy, requiring them to calculate the number of pills to administer. They also need to calculate the amount of medicine to give when drawing up liquid medicine for injection. An order to give 7.5 mg must be compared to the vial, which states, "5 mg per cc." Some medication orders require the nurse to calculate the dosage based on the patient's weight.

We all know that all medications comes with a specific instruction on the amount of dosage a person can take depending on