UncategorizedNursing homework help, The use of controlled substances

          Nursing homework help, The use of controlled substances.  My concerns with ML’s current regimen are the use of controlled substances, for a prolonged period. These drugs are intended for short-term use because they can cause dependency (Visovsky, Zambroski, Hosler, 2019). Since this patient has been taking benzodiazepines (BZN) for what appears to be several years, she will need to be reevaluated and gradually tapered off the medication. Stopping the medication abruptly can lead to physical withdrawal symptoms. The plan would be to taper her off the controlled drugs and prescribe NSAIDs such as Motrin and Tylenol instead. I would also try other non-pharmacological treatments such as physical therapy.

ML has a history of cigarette smoking and alcohol use. Since she will continue taking gabapentin for her nerve pain, she will need to be monitored closely as alcohol interacts with gabapentin and can decrease its effectiveness. Both alcohol and cigarette smoking, can lead to an increased risk of benzodiazepine dependence and put the patient at an increased risk of heart attack and stroke.  Another concern I have is her communication with managing medications, this may be difficult, especially with transitioning care. Ineffective communication due to the language barrier can result in medication discrepancies (Science Direct, 2021)Nursing homework help, The use of controlled substances

Regarding ethical concerns, I believe that beneficence exemplifies the concept of the moral obligation to act in the best interests of others. As healthcare providers, we must practice beneficence in our clinical settings daily by making selections and decisions about how to best care for our patients without causing harm or breaking the law. The attached sample pain contract provided by Pinnacle Interventions Pain and Spine Consultants (Ko, Murray, 2020) is appropriate, and will be signed by the provider and Ms. ML and will be kept in her records. Nursing homework help, The use of controlled substances

Pinnacle Interventions Pain and Spine Consultants (Ko, Murray, 2020)

To ensure safe prescribing, it is important to check the state-run prescription monitoring programs to avoid having multiple prescriptions being filled. Specific information must be included on a legal prescription such as the patient’s name, date, name of the medication, route, dose, quantity to be dispensed, frequency, duration, and signature of the prescriber as well as the DEA number. The pharmacy is also required to provide information about the drug and how it is to be given (Visovsky, Zambroski, Hosler, 2019). Since ML is Latino, having this information in her native language would be valuable. Nursing homework help, The use of controlled substances

If the current list of medication was to be continued, a handwritten prescription for the controlled substances must be presented to the pharmacy.  Emergency prescriptions may be called into the pharmacy if followed by a valid written prescription within 7 days, stating that a previously placed prescription was called in (Trevor, 2015). In some states such as TN, gabapentin is considered a controlled substance and cannot be called into the pharmacy. Losartan and Atorvastatin can be called into the pharmacy. Nursing homework help, The use of controlled substances

Nursing homework help, The use of controlled substances To prevent multiple prescriptions from being filled I would immediately document the prescription information into the state-run prescription monitoring programs such as California’s prescription drug monitoring program (PDMP) and The Ohio Automated RX Reporting System (OARRS) databases that are used to monitor controlled prescription drugs dispensed to patients. According to Jenni (2020), reporting must happen within five minutes of prescription. 

Refill for C-III, C-IV, and C-V can be done within 6 months after initial prescriptions.  Both California and Ohio allow nurse practitioners prescriptive authority for drugs falling into schedule II, III, IV, or V (Med Source Consultants, 2018).Nursing homework help, The use of controlled substances