A 79 year old white male is taking hydrocodone/APAP 10/325 for lower back pain (pt diagnosed with degenerative disc disease several months ago). The physician had written a prescription for Vicodin® 10/325 1 or 2 tablets Q4-6h prn pain with a quantity of 120. Her expectation was that this would last the patient for one month. The patient is now requesting refills about every 10-14 days. He states he has been taking 2 tabs Q4h (12 tablets per day) because "the pain is so bad I just can't stand it!". He also tells the provider he is "constipated so bad it somtimes hurts to sit, bend or walk".
o What is the problem with the way the patient is taking this medication versus the way it was prescribed? o Based on your assessment, it is determined this patient should be converted to extended release morphine for better, more consistent pain control. Perform this conversion and provide an appropriate recommendation (drug, dose, frequency) for the extended release morphine as well as any other recommendations you may have.
Migraine is a major neurological disease that affects more than 36 million men, women and children in the United States. There is no cure for migraine. Most current treatments aim to reduce headache frequency and stop individual headaches when they occur. Let's look at a case example:
• CM is 20 years old female with severe, prolonged 2 to 3 day migraines twice per month. She has difficulty sleeping and is mildly anxious. She occasionally utilizes an inhaler for asthma. o Provide an evaluation of CM's condition including non-pharmacological interventions and treatment options for abortive therapy o Is Cm a candidate for prophylactic therapy, and if so, what option would be best suited to her?