Gentamicin and Oxycontin on the loose!

Insulin type syringe ready for injection. Doct...

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Friday the 13th was so exciting, that I seemed to have missed my blogging! Despite the fact I am writing this the morning of the 14th, it will be “posted on the 13th”.

I love Friday the 13th! And I love full moons! I don’t know why people dread those days. I have interesting experiences on Friday the 13th, and I usually meet new people on full moons. I think it’s just because it opens up conversation with people. This 13th, I went into work planning on working on my Western States presentation. I had gotten some good feedback the day prior, and I found some better statistics to input. BUT, I went behind the counter (first mistake), and I got stuck there for two hours. During that time, I got a script for Gentamicin 80mg TID IM x 5 days for a patient (pt) getting ready for an operation. We have all the injectables other pharmacies won’t carry, so we can get some odd scripts. I had never come across outpatient gent, so I had to review literature to see the best questions to ask the doc.  It’s amazing how quickly you forget things!! He seemed annoyed at the questions, but I reminded him that I was putting my name on that script as well, at which point he relaxed a bit. I also called the patient to get more of the story. Hard to say without cultures and the pt’s chart, but the pt was coming in, and we were going to provide IM injection training anyway.  To make it more complicated, the pt is in a wheelchair so has very little muscle below the waist, where it would be best to inject 2ml of medication. Thank goodness for our RN Katie!

A little later in the day, I got a pain patient ask for me. We had talked briefly the prior Saturday. This is one of those pts on several narcotics, 2 benzos, tramadol, and more. I took her to the back and asked her more questions about her sleep, about what type of pain she has, etc. I find all the time that pts with nerve pain have never tried gabapentin.  I spent some good time talking with her, and said to have her grab me the next time she comes in, as I will put together a diagram of how her meds work (long-acting vs short-acting). We have a pain doc that prescribes insane amounts of medications to pts without explaining how they work. I think I can help a lot of those pts with some decent counseling. I am so glad I had my pain management rotation my fourth year! No one wants to touch narcotics, but I think it’s critical.

Anyhoo, gotta go get ready for the SUP event this morning!


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