Would you give PRN percocet and scheduled Oxycodone together?

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Gabby-RN

Gabby-RN

Specializes in Emergency Nursing. Has 4 years experience. 165 Posts

I have given Oxycontin and Oxycodone together before for patients that have been receiving Oxycontin chronically that are experiencing acute pain.

For example, a patient has been taking Oxycontin 10mg q12h for 2 years for low back pain. Patient is currently hospitalized for an ankle fracture that was surgically reduced yesterday. The MD orders Oxycodone 5mg for moderate to severe pain s/t fracture.

Patient reports 5/10 pain to right ankle and requests prn with 9am meds prior to physical therapy at 930. VSS, I give both meds at 9am. The Oxycontin is for the back pain, the ankle pain is above and beyond the chronic pain and should be medicated.

BlueDevil, DNP

BlueDevil, DNP

Specializes in FNP, ONP. 176 Posts

Oxycontin is tamper resistant and cannot be broken, chewed or dissolved.

I'd probably not hesitate to give them together, but much would depend on circumstances unspecified in the narrative.

BluegrassRN

BluegrassRN

Has 14 years experience. 1,188 Posts

Depends on a lot of factors. In an opioid tolerant pt whose baseline is the scheduled oxy, who is in with something that increases pain, yes I would consider giving them together. It would depend on her current status, her history, her disease process, what she had previously been taking, but yes, under certain circumstances, I would give those two together.

0.adamantite

0.adamantite

Specializes in Acute Care - Adult, Med Surg, Neuro. Has 3 years experience. 233 Posts

Oxycontin is tamper resistant and cannot be broken, chewed or dissolved.

I'd probably not hesitate to give them together, but much would depend on circumstances unspecified in the narrative.

This is interesting! I'm not doubting you, but I'm curious to know how this is achieved. Where I work, Oxycontin appears to be just a regular looking pill. Of course, I've never tried to crush or tamper with it!

TheCommuter, BSN, RN

Specializes in Case mgmt., rehab, (CRRN), LTC & psych. Has 16 years experience. 226 Articles; 27,608 Posts

This is interesting! I'm not doubting you, but I'm curious to know how this is achieved. Where I work, Oxycontin appears to be just a regular looking pill. Of course, I've never tried to crush or tamper with it!
Once upon a time, addicts on the streets were crushing Oxycontin ER, dissolving it with tap water, cooking it with a bent spoon over a lighter and slamming it into their veins. In the past, Oxycontin ER became an immediate release drug if a person crushed, chewed or dissolved it because the pill's outer coating was destroyed.

A few years ago, the drug companies reformulated Oxycontin ER so that it is rendered ineffective if crushed, chewed, pulverized, cooked, dissolved, or otherwise cut.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 12 years experience. 1 Article; 13,952 Posts

This is interesting! I'm not doubting you, but I'm curious to know how this is achieved. Where I work, Oxycontin appears to be just a regular looking pill. Of course, I've never tried to crush or tamper with it!

It's not the same delivery system but if you look at Concerta that may give you an idea

Kaltia

Kaltia

44 Posts

It's protocol on my unit not to give the same pain meds together. With a dependent patient I doubt it would have hurt anything and in the mentioned case I'd highly suspect the patient of self treating. I might give together if the order was very specific but otherwise I try to keep any pain meds sedation things seperate by least an hour. I find that even with the dependent patients it forces them to be little more honest about the amount if relief. And in a lot of cases throne is all they need