Event 1: Meet Mrs. Wright

Mrs. Wright in the Emergency Department

Mrs. Wright's prior opioid use and current inability to remember her home opioid doses, are two issues that contribute to the complexity of her care. She may have a greater tolerance to standard opioids because of her prior use, and her inability to remember her home opioid doses may indicate cognitive impairment or other concerning issues.

Test Your Knowledge

Question 1

Opioid risk mitigation and medication reconciliation.

Mrs. Wright was asked what pain medication she is taking. Is that all that should be confirmed for her pain medications?

Correct. Please always consider the following strategies to confirm pain medication: Look at the PDMP Look at an old note Talk to her outpatient pain doc prescribing the medicine Call the pharmacy Look at her prescription bottles Ask her husband or family member

Incorrect

Question 2

Which of the following are good strategies to use to confirm her pain medications? (Choose all that apply.)

Correct

Nurse Station

Mrs. Wright's Daily Medications

Norco 10mg every 4 hours
Oxycontin 20mg twice a day
Conazepam 1mg three times a day

What is the Prescription Drug Monitoring Program

The Prescription Drug Monitoring Program, or PDMP, is a statewide electronic database of controlled substances dispensed in the state.

Mrs. Wright's PDMP

Mrs. Wright's Prescriptions
Filled	ID	Written	Drug	Qty	Days	Prescriber	RX#	Pharmacy	MME/ID	Pymnt Type	PMP
3/16/2018	1	3/16/2018	Oxycodone extended release 20 mg	60	30	CO MO	1234567	DRUGS(1000)	60	Medicare	AL
3/16/2018	1	3/16/2018	Hydrocodone-Acetaminophen 10 mg	180	30	CO MO	1234568	DRUGS(1000)	60	Medicare	AL
3/16/2018	1	3/16/2018	Clonazepam 1 mg	90	30	CO MO	1234569	DRUGS(1000)	0	Medicare	AL
2/14/2018	1	2/14/2018	Oxycodone extended release 20 mg	60	30	CO MO	1234565	DRUGS(1000)	60	Medicare	AL
2/14/2018	1	2/14/2018	Hydrocodone-Acetaminophen 10 mg	180	30	CO MO	1234566	DRUGS(1000)	60	Medicare	AL
2/14/2018	1	2/14/2018	Clonazepam 1 mg	90	30	CO MO	1234561	DRUGS(1000)	0	Medicare	AL
1/15/2018	1	1/15/2018	Oxycodone extended release 20 mg	60	30	CO MO	1234561	DRUGS(1000)	60	Medicare	AL
1/15/2018	1	1/15/2018	Hydrocodone-Acetaminophen 10 mg	180	30	CO MO	1234562	DRUGS(1000)	60	Medicare	AL
1/15/2018	1	1/15/2018	Clonazepam 1 mg	90	30	CO MO	1234561	DRUGS(1000)	0	Medicare	AL

Concurrent Opioid and Benzodiazepine Use

Concurrent opioid and benzodiazepine use adds to the complexity of Mrs. Wright's care.

Test Your Knowledge

What should you do next to help Mrs. Wright's pain?

Incorrect

Correct

Pain Consult

Inpatient Pain Service Visit with Mrs. Wright

Test Your Knowledge

Question 1

What are the best ways to confirm a patient's opioid medication(s)?

Incorrect

Correct

Question 2

Once you have confirmed a patient's outpatient pain medication program, what is the best next step for pain management?

Correct

Incorrect

Question 3

What does the Prescription Drug Monitoring Program (PDMP) show?

Incorrect

Correct

Incorrect