Is Tramadol part of your Narc count?

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  1. This is a discussion on Is Tramadol part of your Narc count? in General Nursing Discussion, part of General Nursing ... Just wondering. I work a couple of LTCs and LTACs as agency. Some places have Ultram in their lock...

    by Oct 20, '09
    Just wondering. I work a couple of LTCs and LTACs as agency. Some places have Ultram in their lock boxes and its part of the narc count. Others have it in the regular pill drawer. What is your facility practice, and do you know the rationale for locking it up? Is it a highly diverted pain med?
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    by Alibaba Oct 20, '09 11:39 am
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  2. 30 Comments so far...

  3. Oct 20, '09 by
    Quote from Alibaba
    Just wondering. I work a couple of LTCs and LTACs as agency. Some places have Ultram in their lock boxes and its part of the narc count. Others have it in the regular pill drawer. What is your facility practice, and do you know the rationale for locking it up? Is it a highly diverted pain med?
    apparently, every once and awhile it does "go missing" when not on count......i wonder what the DEA thinks of having a noncountable in the narc drawer?
  4. Asst. Admin
    Oct 20, '09 by
    It's in our narc box--we primarily use it in detox with phenobarbital.
  5. Oct 20, '09 by
    no, it's not. No issues with refills, does not require pre-authorization for meds.
  6. Oct 20, '09 by
    Well, although it's non-narcotic, it has some action as a Mu (opioid) receptor agonist. I don't think it's had much problem with diversion/ recreational use but I have heard of some. I seem to remember (but very well could be wrong) that it was C-IV when it first came out then was approved as a no scheduled substance? I was in peds when it was introduced so only saw it if I floated.

    Oh, and no, we don't count it where I work now.
  7. Oct 20, '09 by
    I've never noticed them going missing. We do not count them.
    sharpeimom and KMarie RN like this.
  8. Oct 20, '09 by
    Thanks for all the replies. Just think its weird that some places count it and some do not. This one place (LTC), I think the doc is in love with ultram coz in a count of 60, 15 are ultrams. Sooo time consuming. But I guess if it prevents diversion, then so be it.
    The other strange thing is that the pharmacy (omnicare) sends count sheets with the ultrams in one facility but the same pharmacy does not send the count sheets in another facility where they are not counted. So I guess each facilty has a different pharmacy protocol. Maybe I will speak to a pharmacist one of these days about it.
    Last edit by Alibaba on Oct 20, '09 : Reason: additional info
  9. Oct 20, '09 by
    It is where I am now.
  10. Oct 20, '09 by
    Tramadol is a narc at my job. Apparently, it was the pharmacy's decision.
  11. Guide
    Oct 20, '09 by
    Nope, not at my place.