FDA orders major changes for narcotic/acetaminophen painkillers - Page 2

i just read an article on Medscape, 51% of acute liver failure (ALF) in the US in 2003 were due to acetaminophen. England and France have put limits on how much can be sold in a package (16g and 8g respectively). Those limits reduced their incidence of ALF to close to nil. Here we can buy it by the pound.

I know that once the pharmacy patients hear about this I'll have a lynch mob going after me! People were...well...ANGRY about the Darvocet recall. Downright angry.

OK, I for one, fail to see what the big deal is. There will still be a Hydrocodone/APAP option (Norco).

The people suffering liver failure are probably those for whom a month = 9 to 14 days (as in a 30 day supply of Vicodin only lasts that long). I have not personally seen a patient (and I work with post-ops in clinic) who needs breakthrough pain management and goes after the tylenol. They take another vicodin or two.

Plus, the world of writing prescriptions for hydrocodone/APAP just got easier. Before, I had to deal with:

• Vicodin
  
  • 5/500
• Vicodin ES
  
  • 7.5/750

• Vicodin HP
  
  • 10/660

• Lortab
  
  • 5/500
  • 7.5/500
  • 10/500
• Lorcet
  
  • 10/650
• Norco
  
  • 5/325
  • 7.5/325
  • 10/325

It becomes a headache when a patient calls and says, "vicodin doesn't work for me/vicodin makes me sick/I'm allergic to vicodin" and the next statement out of their mouth is "I can only take lortab."

We have been using Norco for several months now instead of Lortab. Patients get confused with the names.

I'm just waiting for the day when the FDA gets rid of Fentanyl Patches.

I can't believe the % of patients that are prescribed vicodin/lortab/percocet etc. Truly astonishing. I have come from another country so maybe I'm just not used to it, but honestly, I think 90% of my patients here are prescribed these drugs for varying "pain" issues [and they aren't pain clinic patients or anything, I work in cardiac]. I think at some point the prescribers do need to take responsibility for what they are dishing out to people... just say no or send them to specialist pain clinics.

It can only be a good thing cutting down on the combination products - it's clear that people aren't aware what they are taking or the ramifications of such.

Our computerized MAR calcultes dosages of acetaminophen for past 24 hours and pops up a warning message after 3g have been administered to warn of overdose. It won't let you administer over 4g in 24 hours.

My middle sister is waiting on a liver transplant for just this reason. Almost all of her meds contained acetaminophen.

I think one of the worst tylenol overdoses I've seen was a young person who drank a bottle of nyquil. For fun. I welcome the advent of only having one strength of tylenol in the hydrocodone pills, but OTC in my opinion represents just as large of a problem.