Is Tramadol part of your Narc count? - page 2

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... Read More

  1. by   CathyLew
    we just switched to an automated med machine, and the PHA can set any med to verify quantity. He does this with all narcs of course, and other things that seem to evaporate. Previcid is prompted to count. And durring the flu season, all antibiotics and antivirals are set to prompt a count.

    to him its inventory control, and if he uses it like that, there arn't any red flags.
  2. by   Alibaba
    interesting how different things are run in different places. Maybe if a facility has had a hx of pain pills 'walking away' then they decide to enact the count for anything that may be a temptation.
  3. by   sasha2lady
    It is in our narc count also. Our pharmacy downsized and we had to switch to one under the same name but in a closer location a few months ago and with the new one they sent this med out as a non control and we had to make out new narc count sheets for boss asked them about it and they said it was up to us.....we could do it either way...and since we've been counting it for x amt of years we just kept it this way. Before it was put with our narcs was easy for them to come up missing and refills needed too thats probably how it got started where I work. But really ...if you think about LTC its very easy for a nurse to divert meds.....huge patient loads given to one nurse at a time.....very easy to do for those that are into theft.
  4. by   AllieSparksRN
    I'm a RN at a post-op rehab facility (knees, hips, that kind of thing). Tramadol is not considered a Narc at our facility. Oxy & Fentanyl patches are the main/most popular ones we count daily.

    How many times a day does your facility do a Narc count? Ours is once a day....
  5. by   cherrybreeze
    It isn't where I work (but then again, neither are the elixirs like Lortab and Tylenol 3, due to "not enough room in the PYXIS. They send it up in multi-dose bottles, I've been trying to get them to change that practice for years).

    Anyway, back to the Tramadol.

    While it isn't legally considered a controlled substance, it acts very similarly to codeine. People can and do get addicted to it, and stopping it suddenly causes withdrawal symptoms (and seizures). Google it and you'll find a bunch of info and postings on forums re: tramadol addiction. It's more common than you'd think.
  6. by   VickyRN
    It is not included in the narc count at my secondary employer.
  7. by   belgarion
    It's locked up and counted at each shift change where I am. I think I've given it maybe 3 times in the last month.
  8. by   talaxandra
    We have pre-printed count books for schedule 8 (narcotics/drugs of addiction) and schedule 11 (non-narcotic/drugs of dependency) meds. Although tramadol's pre-printed in the schedule 11 book it isn't locked up, perhaps because we use it so rarely that a sudden drop in stock would be obvious.

    After a drug-dependent former staff member stole a PCA key and syringe from a post-op patient (when confronted she said she was the anaesthetist and ceased the infusion on the chart!) we now include PCA keys in the count, which is done TDS at shift change with one person from each shift doing the count.
  9. by   NurseKatie08
    Nope, not counted at my facility. I have two patients on it right now, and it's right in with their routine meds.
  10. by   Not_A_Hat_Person
    Quote from AllieSparks
    How many times a day does your facility do a Narc count? Ours is once a day....
    Three times a day, at change of shift.
  11. by   YngAnabaptistRadical
    We use an AccuDose where I work, and the meds kept in their are either the controlled substances (those ones will come up as a narc discrepency), emergency meds like Nitro (no count discrepencies, but you have to count how many are left when you take one out just to make sure we don't run out) and commonly given PRN meds like Senna and Phenergen. That we we don't have to wait for pharmacy to send the meds to us to deliver them tot he patients.

    We don't have a "narc count." Narc discrepencies show up on the AccuDose screen.

    Ultram is not in the AccuDose. That is sent from pharmacy and we keep it with a patient's other meds.

    *~Naomi Grace~*
  12. by   necc2008
    I work in a LTC and tramadol was not in the narc count for a while, but then they found a nurse was taking them, so they have since put them in our narc count.
  13. by   Alibaba
    Interesting replies. I hadn't given tramadol very much until I started working this one LTC. Seems like everyone is on it scheduled and prn. (the other biggie there is darvocet.) I think it's just the doctor's way of getting away with not prescribing narcotics. Then again, their pain seems pretty well controlled on the tramadol.