How much pain medication is "too much pain medication"?

TiredMD · Jan 2, 2009

This is a stupid and pointless analgesic regimen. Sounds like something you'd give to someone as a placebo because you're worried they'll misuse narcotics.

november17, ASN, RN · Jan 4, 2009

This is a stupid and pointless analgesic regimen. Sounds like something you'd give to someone as a placebo because you're worried they'll misuse narcotics.

I prefer to refer to those types of patients as "hypersensitive"

Phillygryl, LPN · Jan 20, 2009

Another client in the facility was on Vicodin q 8 hrs prn in addition to the tylenol 325 prn. She had surgery for cataract removal and the doctor ordered additionally Percocet q 6 hrs prn.

One of the nurses gave the client the Vicodin at 7 am and then because the client is so drug seeking erroneously gave her the Percocet which resulted in him being written up for double dosing. My question is this really his fault or should one of the orders been d/c'd. What is the since of having all of these prn orders?

By the way, as of today, the client is the hospital!!!! She became edematous in the face and non responsive!! the client has a history of CHF and COPD!! What do you think

Lurksalot, BSN, RN · Jan 20, 2009

I work in an assisted living facility! A client there who needs knee surgery but is refusing it has Hepatitis C.
A chronic user of pain medication and a former IV drug abuser gets 500 mg of Tylenol and 50 mg of Trammadol q 6 hrs. She also has prn order for (2) 325 mg of tylenol also q 6 hrs additionally, she has an order for 1 mg of Ativan q 6 hrs. Everyone administers it she even complains that at night she is given 1000 mg of tylenol!!! Is Tylenol contraindicated for people with Hepatitis C or not???

:eek:

BradleyRN · Jan 22, 2009

I can do math - I'm assuming everyone here can but thanks for pointing that out. I'm sure the doctor will be impressed by the ingenious math skills displayed when this is pointed out. And she theoretically could get >1000mg if someone is giving her a prn dose on top of a scheduled dose. I still don't think 4g / 24 is a large dose but whatever!

Certainly you can do math, which is why i was surprised when you claimed that 4600mg in 24h was "a pretty low dose of Tylenol". Your sarcastic impression that the doctor would not care to know this info is also inaccurate. I have caught this mistake a few times, and the doctors or NP's were always happy to adjust the dose, and thankful for the heads up.

Finally, 4g/24h is not just a large dose, it is the largest dose. As you will see in TraumaRU's link, 4g/24 hr is enough to "cause severe liver injury in some people, sometimes even resulting in death".

We are not in a competition here. We are on the same team. You gave faulty information, so i corrected you. You should click "thanks" and move along, instead of trying to argue that you are right when you are exactly not. :twocents: