Matthew A. Torrington, MD, introduces our first patient case, a 27-year-old man presenting with injuries from a car accident.
Matthew A. Torrington, MD: Our first case is a 27-year-old man who presented with extreme pain in his right ankle, ribs, and arm after getting into a car crash. He has a past medical history, significant for substance use disorder, high blood pressure, and diabetes. He works from home, drinks 1 to 2 cups of hard alcohol when he’s stressed, smokes a pack of cigarettes a day, and is married with 4 children. He takes buprenorphine 2 mg per day, lisinopril 20 mg, and metformin 500 mg. He came into the emergency department [ED]. In the first hour upon arrival at the ED, he described pain as 10 of 10. He got 1 g Tylenol IV [intravenous]. In the second hour, he had 6 of 10 pain. There was no comment about his pain and what they gave him then. In the third hour, 7 of 10. In the fourth hour, 10 of 10. The imaging showed a hairline, a broken ankle, a broken rib, and a small hairline fracture on his clavicle. CT and MRI showed no tissue or brain damage. He got a cast for his right ankle and then got started on low-dose opioid therapy, Percocet 5/325 [5 mg oxycodone hydrochloride, 325 mg acetaminophen], 1 every 4 to 6 hours as needed for pain for 5 days until he gets to his primary care provider.
This transcript has been edited for clarity.
Pharmacists Should Take a Proactive Approach When Addressing Controlled Substance Concerns
March 24th 2024At this year’s American Pharmacists Association Annual Meeting & Exposition, Mark Garofoli urged pharmacists to develop strong documentation practices and go beyond baseline federal regulations to care for patients with red flags.
How Emotional Intelligence Helps Pharmacists Handle Controlled Substance Concerns
March 23rd 2024Pharmacists must uphold their “corresponding responsibility” to address controlled substance concerns among patients while balancing safety and respect, said Mark Garofoli at this year’s American Pharmacists Association Annual Meeting & Exposition.