What is the highest regular dose of Oxy that you have seen

[~Mi Vida Loca~RN, ASN, RN]

Sorry to steal the same title as the BP one. Patient was in the ER today, was reviewing home meds, and she was on

130mg Oxycontin Q TID (not 3 divided doses) and 30 mg Oxycodone Q TID I was shocked, the ER nurse I was with has been a nurse for 22 years and she had never seen a dose this high either for someones personal home meds.

Just curious what others have seen.

[etaoinshrdluRN]

I don't know about oxycodone, but I was shocked to have a patient with a 100 mcg fentanyl patch at one time. She must have been hurting like hell to have had that prescribed.

[Flo., BSN, RN]

160mg Oxycontin tid for a base. 30mg roxicodone q 3-4 hrs for breakthrough pain.

After surgery PCA dilaudid , robaxin iv, skelaxin and valium were added. All this and the pt was on room air! Pt had a massive back surgery.

[Up2nogood RN, RN]

The highest dose I have given of oxycontin was 80 mg TID.

I once had a breast ca pt with metastasis to the spine who took 24mg of oral dilaudid Q 4 hrs with 20mg oxycodone Q 3 hrs for breakthrough pain. This pt had had a pain pump but it had gotten infected and had to be removed hence the high tolerance to dilaudid.

Also....

Just recently I was giving a patient a 4mg IVP of dilaudid nearly Q hour on top of having a internal pain pump with dilaudid infusing continuously plus was getting fentanyl pushes for *breakthrough* pain along with oral diazepam and flexeril. Pain remained 8/10 and hopefully would be seen by pain management the next morning to increase the 40 mg BID oxycontin dose to at least TID and add a fentanyl patch.

[tk0224]

I've seen 80mg of Oxycontin q6h, with Percocet QID PRN.

[caliotter3]

I must be out of touch. When I read the title to this thread, I thought you were talking about oxygen. For what it is worth, my patient is on 8 liters.

[blondy2061h, MSN, RN]

I must be out of touch. When I read the title to this thread, I thought you were talking about oxygen. For what it is worth, my patient is on 8 liters.

LOL, hilarious!

[morte, LPN, LVN]

pah, light weights, all of you, lol....360/280/360.....still talking, but bed bound.

[kanzi monkey]

70 mg dilaudid po q2h--walking to the nurses' station 5 minutes early for each dose. chronic back pain/addictive disorder--the man certainly understood the principle of "no ceiling effect" with narcotics.

(yes, dilaudid)

[MECO28, BSN, RN]

I'm a nursing student and my classmate walked into post-conference today with a fistful of empty oxy blister packs and announced that his patient had taken all of them in a six hour period. (per physician's orders and under the guidance of a staff nurse) I added them up and...240 mg! I wasn't in that unit and didn't see the order but since my classmate said he had PRN oxy every 3 hours, I'm guessing he had 120 mg Q3.

I had a knee infection and took 10 mg a couple of summers ago and that made me pass out cold! This guy had 120 mg and left the hospital shortlly afterwards to stroll down to the corner store for some cigarettes...wow.

[Hospice Nurse LPN, BSN, RN]

I don't know about oxycodone, but I was shocked to have a patient with a 100 mcg fentanyl patch at one time. She must have been hurting like hell to have had that prescribed.

My husband wears 150 mcg fentanyl patch (100 + 50) w/ lortab 10/500 Q4-6 for breakthrough pain. Usually takes 4-5 lortab Q day. Still up and about, driving, etc.

To answer the original question, I had a pt on OxyContin 180 mg TID w/ morphine sulfate (Roxanol) 1cc Q 2-3 hours for breakthrough pain. Your pt has probably been on the meds for a while. Remember they are going to develop tolerance for it and need increasingly higher doses.

[britgirl37]

Ok... so its not oxy, but I had a pt (dx bone cancer) on 560mg MScontin bid, with fentanyl patch 175mcg, pt was up with minimal assist and sharp as a tack!!