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It is not uncommon for drug abusers to alter prescriptions f…

It is not uncommon for drug abusers to alter prescriptions for opioids. Common alterations to watch for include changing the quantities (i.e., 10 to 40, 30 to 80, or adding a 1 in front of the number—20 to 120) and adding refills where none were indicated. Prescribers can help deter this practice by spelling out the quantities and refills or by writing no refill or non rep if no refills are desired. Look at the following prescriptions and see if you notice anything that seems out of place. Then explain what, if anything, is out of place and what you think the pharmacy might do in all four scenarios.. a.    dental—Vicodin #42—1 po q6h prn dental pain—refill 4 times. b.    bone break—Tylenol /codeine 30mg #30—1–2 po q3–4h prn leg pain—refill 4 times. c.    cancer patient—morphine Intensol 20mg/ml #120ml—0.25 to 1 ml po q1–2h prn breakthrough pain—no refill d.    emergency room—Demerol 50mg tablets #110—1 po q4–6h prn migraine pain—0 refills

Pepper has an echocardiogram after surgery, and the veterina…

Pepper has an echocardiogram after surgery, and the veterinarian sees shadows that suggest the possibility of heart disease.  Pepper has no symptoms, however, and is sent home after recovering well from surgery.  Because Pepper is asymptomatic, the veterinarian instructs the owner to monitor for rapid breathing, or _____________, which can be the first sign that heart disease has progressed to heart failure.