A patient with moderate to severe chronic pain has been taking oxycodone [OxyContin] 60 mg every 6 hours PRN for several months and tells the nurse that the medication is not as effective as before
The patient asks if something stronger can be taken. The nurse will contact the provider to discuss: a. administering a combination opioid anal-gesic/acetaminophen preparation.
b. changing the medication to a contin-ued-release preparation.
c. confronting the patient about drug-seeking behaviors.
d. withdrawing the medication, because physical dependence has occurred.
B
Oxycodone is useful for moderate to severe pain, and a continued-release preparation may give more continuous relief. Dosing is every 12 hours, not PRN. A combination product is not rec-ommended with increasing pain, because the nonopioid portion of the medication cannot be in-creased indefinitely. This patient does not demonstrate drug-seeking behaviors. Physical depen-dence is not an indication for withdrawing an opioid, as long as it is still needed; it indicates a need for withdrawing the drug slowly when the drug is discontinued.
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