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Old 10-26-2006, 01:11 PM   #1
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Hey, question about pain management drugs (short term use):

Hi, I posted something similar to this on the Drug Interactions board, but I figured that you guys would probably know more about pain medications, so here it goes:

My uncle had to have surgery on his leg, and the doctor won't prescribe any more Percocet because he's afraid that he might become dependent on it. But, he offered to precribe either Tylenol #3 or Darvocet. Which is stronger?

Also, would Diclofenac (Voltaren) be any more effective? Or is there some reason that you can't use that because it would cause bleeding at the inscision site (I know that Motrin can cause bleeding, and that diclofenac is also an NSAIDS, so that might do it too).

Thanks so much!!!!!!

 
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Old 10-26-2006, 01:59 PM   #2
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Shoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB UserShoreline HB User
Re: Hey, question about pain management drugs (short term use):

Hi Lelissa, Personally, I don't se much difference in strength between the two, But I'm sure there are folks that have an opinion and thinks the strength difference is noticable. He really won't know until he tries either, They are a big step down from oxycodone. Most docs step down to hydrocodon for a few weeks before ending all pain meds or using one of them. Depending on your Uncles unique body chemsitry and how long he took the oxy, he may feel crappy for 3-5 days after his last dose of oxy. Bottom line, all surgeons are different and they pretty much have control over his post opp pain.

As far as an NSAID. The right time to bring that up is when your complaining about relief from the milder drugs. I don't know what surgery he had, if they need bone to grow into a TKR ? how recent ist was and I'm not a doc. Ask him if you can supplement with OTC pain meds like Motrin.

Good luck, Dave

 
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Old 10-26-2006, 07:55 PM   #3
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Re: Hey, question about pain management drugs (short term use):

Dear Melissa,

Shoreline's right. In the practical sense, there really doesn't seem to be all that much difference in the "feeling" of the two drugs you mentioned--Tylenol with Codeine and Darvocet. Their differences in the relief they each give probably varies with the person.

However, Tylenol with Codeine is a Schedule III opiate, while Darvocet is in the Schedule IV group. The thinking is that the lower the Schedule Number, the less addiction potential there is. For instance, Percocet (Schedule II) feels much stronger to most people than Lortab (Schedule III).

I also agree that moving a patient from Percocet all the way down to Codeine or less might cause some withdrawal symptoms. Furthermore, there is such a huge difference between your Uncle becoming "dependent" vs your Uncle becoming "addicted". Most of us here on this Pain Management Board are DEPENDENT on our medications. That simply means we are used to our medications, and our bodies--over time--might require higher dosages to obtain the same amount of relief. ADDICTION, though, usually involves a person misusing the pain medication in order to get high. Finally, a doctor can easily help a person who is DEPENDENT by gently and slowly lowering the dosage levels over a period of time.

Let us know if we can help you further.

Sincerely,
Conductor (Jon)

 
Old 10-27-2006, 07:52 AM   #4
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Re: Hey, question about pain management drugs (short term use):

Thanks everyone!!! That was really helpful, and I'll pass the info on to him!


Quote:
I also agree that moving a patient from Percocet all the way down to Codeine or less might cause some withdrawal symptoms. Furthermore, there is such a huge difference between your Uncle becoming "dependent" vs your Uncle becoming "addicted". Most of us here on this Pain Management Board are DEPENDENT on our medications. That simply means we are used to our medications, and our bodies--over time--might require higher dosages to obtain the same amount of relief. ADDICTION, though, usually involves a person misusing the pain medication in order to get high. Finally, a doctor can easily help a person who is DEPENDENT by gently and slowly lowering the dosage levels over a period of time.
Yeah, I tried to explain that to my uncle, but he insists that the doctor said "addicted." I told him that he was probably wrong though because since he was taking the minimum dose (like half of a 5-325 I believe) it wouldn't make much sense that he would become "addicted," since he surely wasn't taking enough to get high, or for any other purpose than as-needed and to relieve legitimate pain. (His leg was impaled on a metal rod, completely ripping his muscles out, and then he had an infection, then a skin graft, etc., all within the last 2 weeks.) I think that one more week (totalling 3) would seem rather reasonable for pain medications for an injury of that caliber, but I'm not the doctor. LOL Thanks again!!!

 
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