Content area
Full Text
A 54-year-old woman experienced significantly elevated hydrocodone/paracetamol trough level following the concomitant administration of duloxetine with hydrocodone/ paracetamol [indications, routes and outcomes not stated; not all dosages stated].
The woman presented to the Pharmacy Pain Medication Therapy Management Clinic for prescription pickup. Her medical history included degeneration of lumbar intervertebral disk, hyperlipidemia, type II diabetes, hypertension and bipolar disorder. Her previous medications included diazepam [Valium], hydrocodone/paracetamol [Norco], unspecified opiates and benzodiazepines. She was under treatment with gabapentin, duloxetine, tizanidine and hydrocodone/ paracetamol [hydrocodone/acetaminophen] 7.5/325mg one tablet every 6 hours as needed. A random urine drugs of abuse assay was performed as a part of the controlled substance agreement. Based on the urine sample's visual inspection, it was suspected that she had submitted a highly diluted urine sample. This observation by the clinical team prompted for further investigation. Specimen...