A patient who has chronic pain and who takes oxycodone (Percodan) ...

[laurencescou]

A patient who has chronic pain and who takes oxycodone (Percodan) calls the clinic to ask for a refill of the medication. The primary care NP notes that the medication refill is not due for 2 weeks.
 
  The patient tells the NP that the refill is needed because he is going out of town. The NP should: a. fill the prescription and document the patient's explanation of the reason.
  b. review the patient's chart to see if this is a one-time or repeat occurrence.
  c. call the patient's pharmacist and report suspicion of drug-seeking behaviors.
  d. confront the patient about misuse of narcotics and refuse to fill the prescription.

Question 2

A patient who has asthma and who is known to the primary care NP calls the NP after hours and asks for a refill of an albuterol metered-dose inhaler. The patient has not been seen in the clinic for more than a year. The NP should:
 
  a. call the pharmacy to order the medication with several refills.
  b. send an electronic prescription to the pharmacy for one time only.
  c. send the patient to the emergency department for evaluation of symptoms.
  d. refill the drug and tell the patient that an office visit is necessary for further refills.

[dominiqueenicolee]

Answer to Question 1

B
When patients fill prescriptions early for drugs that have abuse potential, providers should be alert to possible abuse. The first step would be to see if this is a one-time occurrence or a pattern. Providers should do this before refilling the prescription. If this is a pattern, the pharmacist should be notified. Patients should be confronted if a problem is apparent, and practitioners should not refill the prescriptions.

Answer to Question 2

D
The patient needs the medication and is known to the NP so a refill is not inconsistent with practice guidelines. However, further refills should not be provided until the patient is seen and has an updated asthma action plan. The patient should be informed of this; simply refilling the prescription sends a message that it is acceptable to get refills without being seen.

[laurencescou]

TY

[dominiqueenicolee]

You're welcome