Lack of understanding Twice as potent as morphine
Less ‘stigma’ compared with morphine
Addiction Studies identifying oxycodone as being more
desirable Studies identifying oxycodone as being more
addictive (approx. 2 weeks)
55 year old female Presented to ED Diagnosis (from iSoft) ▪ Sprain and strain of unspecified joint and ligament of
trunk (lumbar) ▪ Injured lower back at work 4 days prior to presentation
Discharged with paracetamol, ibuprofen ▪ 30 x OXYNORM 5mg
Pharmacy received phone call from GP expressing concern
Obstetric case post c-section – a mother described receiving a medication that was so great all she wanted was more of the medicine and didn’t care about baby ▪ (on reflection it ‘was scary’)
Post orthopaedic surgery – patient went back to GP for
more because they were so good and was very angry when GP declined script. ▪ (patient reflected that they were really addictive)
Cardiothoracic surgery patient – kept on oxycodone (3+
years post surgery). GP unable to stop and now unlikely to ever be off opioids for the rest of his life (being changed to Methadone).
Significant discussions with our Acute Pain Service Agreement to use morphine first line ▪ Oxycodone had become the first line agent ▪ Oxycodone removed from the MedChart ‘quickacol’
Education, education, education Junior Doctor protected teaching Ward in-service Clinical Nurse Educators Grand Round
Discussion at local Medicine Review Group meetings and District Medicine Management Meeting
Education comprised of Background of problem WHO anaglesic ladder ▪ Discussion of different steps
Philosophy of what we were trying to achieve Points to remember ▪ To highlight the lack of understanding and reinforce the
challenges we see. ▪ Comparison with morphine
Prescribing tips ▪ Quantity
Southland Hospital Intern Pharmacist follow up project - audit ▪ To determine if the education had had an on-going
effect ▪ To determine if oxycodone is being used appropriately
for pain ▪ 2nd line which is consistent with hospital wide and Ministry of
Health campaigns
▪ To determine use on discharge ▪ Short term ▪ Long term
0
500
1000
1500
2000
2500
3000
Uni
ts
Oxycodone Use
Capsules
Tablets
Linear (Capsules)
Linear (Tablets)
0
200
400
600
800
1000
1200
1400
Uni
ts
Morphine Usage (Units)
Cap
Tab
Linear (Cap)
Linear (Tab)
Thank you!