Question

Ms S is a 54-year-old female comes to you to establish care you are the FNP. She tells you she typically takes MS contin 30mg PO TID and Norco 10/325mg PO q4 hours for breakthrough pain and has taken those for more than one year continuously.

She tells you her pain management doctor stopped all her drugs because of her "liver issues" and told her to establish care with a PCP. She reports having chronic LBP, migraine headaches, type II diabetes, hypertension and fibromyalgia. Her other drugs include Lexapro 20mg PO QD and Ativan 2mg PO TID of which were stopped for her "liver issues" and she reports she needs a refill of these as she ran out this morning. she requests that you also fill her pain drugs until she can return to pain management, of which her next appointment is more than one month away.

QUESTION TO ANSWER:

What in her schedule II-controlled drug use indicates that she has a medical condition (illness, disease or injury, pathophysiology or symptoms) or history of a medical condition that warrants that you should prescribe (or furnish) a schedule II-controlled substance schedule II drug and what if any drug would you prescribe at this point in her treatment?

Answer 1

The patient says that she typically takes MS Contin 30 mg p.o. t.i.d. and Norco 10/325 mg p.o. q.4 hours for breakthrough pain and has taken those for more than one year continuously. MS Contin contains morphine, which is a schedule II drug and Norco contains hydrocodone These facts about schedule II controlled drug use indicate that she has a medical condition or history of a medical condition that warrants that she should be prescribed a schedule II controlled substance schedule II drug. I would not prescribe any drug but would recommend other pain relief measures such as rest, exercise, sleep, yoga, diet etc for pain relief. It would be inappropriate for me to prescribe any drug for a patient with multiple comorbidities.