Question

You are a floater pharmacist working at a new pharmacy  on the weekend in the outskirts of an urban area. Towards the end of the day, Ben approaches your pharmacy counter with a new prescription for Percocet 10/325 #60 with directions to take 1-2 tablets every 4-6 hours as needed for severe pain from Dr. Stevens at the local urgent care facility. Ben states that he has just been in a multi-car accident, and is suffering from back and leg pain. Since he is a new patient, he is asked to provide more comprehensive medical information. In addition, a new state law requires prospective review of the prescription drug monitoring program (PDMP) before dispensing any opioid prescription. You complete review of Ben’s PDMP report (see below) and ask him about it. Ben reports that he has been working as a temporary concrete layer, and does not have benefits. He had been covered by Medicaid, but since moving to North Dakota, he hasn’t applied for it. He reports that he frequently experiences pain associated with his work. His medical information is below.

Age: 39 years

Past medical history: depression, anxiety, attention deficit disorder, alcohol use disorder, allergic rhinitis

Family history: mother (alive) with type 2 diabetes, depression, and hypertension; father (deceased) with history of alcohol use disorder, hypertension, cirrhosis

Social history: tobacco use (+); alcohol (+), living alone and not in the same city as the rest of his family

Medications: sertraline 50 mg daily; alprazolam 1 mg TID; cetirizine 10 mg daily (OTC)

PDMP Record:

Medication and dose	Instructions	Quantity (date)	Refills remaining	Prescriber	Pharmacy
hydrocodone/acetaminophen 7.5/325	1 tab every 4-6 hours prn pain	15 (10 days ago)	0	Smith	ABC
Hydrocodone/acetaminophen 7.5/325	1 tab q6 prn pain	30 (15 days ago)	0	Jones	123
Methylphenidate 10 mg	1 tab BID	60 (15 days ago)	0	Jones	123
hydrocodone/acetaminophen 5/325	1 tab every 4-6 hours prn pain	30 (20 days ago)	0	Hite	XYZ
Alprazolam 1 mg	1 tab TID	90 (20 days ago)	1	Hite	XYZ

14. Part II of this case study has explored options for controlling opioid misuse on the population and the individual level. Write a half- to one-page summary of the roles of the PDMP and screening using the ORT to reduce opioid misuse on an individual and a population level.

Answer 1

Prescription drug monitoring program(PDMP) maintains electronic database monitoring to track dispensing and prescribing the controlled prescription drugs to patients to find out and prevent prescription drug misuse. federal government having control of opioid misuse and overdose to promote safety and responsible for distributing opioid medications. Disease control and prevention (CDC) action for prescribing opioids for chronic pain created standards for balancing benefits and risks for pain management. PDMP reduces the risk of overdose deaths and enhances the use of medication-assisted treatment. patient should discard their expired medication with FDA guidelines. prescription, over the counter medicine, dietary and herbal supplements should be informed to doctors before use. pharmacist should help the patient understand drug action, side effects, and follow-up. pharmacist and physicians should use PDMP guidelines for tracking opioids prescription and dispensing patterns in patients. Abuse -deterrent formulations(ADF) opioids should be shown to reduce the illicit value of drugs.