• N&PD Moderators: Skorpio | thegreenhand

  • Neuroscience & Pharmacology Discussion Welcome Guest
    Posting Rules Bluelight Rules
    Recent Journal Articles Chemistry Mega-Thread
    FREE Chemistry Databases! Self-Education Guide

Why don't doctors all perscribe the same narcotic to all pain patients?

A

Alien47

Bluelighter
Joined
Aug 22, 2015
Messages
127
Ok I'm not sure if this is in the right area sry if it isn't still kinda new to knowing where everything gets posted

Ok here's my question why don't all pain patients get perscribe the same pain meds like I know some are stronger then the other like if ur pain is really bad u mjght get like methodone and if it's not as bad maybe Hydrocodone but I'm talking like u have chronic pain but someone who has the same problem gets a different medicine example say 4 ppl have chronic ankle pain same level of pain same reason but one gets oxycodone one gets oxycotin one gets Vicodin on gets Percocets one gets Hydrocodone and on gets methodone like why do they give so many different opioids for the same problem with the same level of pain some of those meds are the same thing but why give one Vicodin and one Hydrocodone what's the difference and why give one oxy and one methodone like it doesn't make sence to me those are two completely different meds so to sum up my question again why do doctors perscribe different medicine for the same problem

Also a side question why are there multiple names for the same drug? Like Vicodin Hydrocodone norco zydone lortab lorcet hycet maxidone stagesic verdrocet xodol zamicet and Zolvit like all of these meds are all the same but have different names and are perscribe to different ppl with the same problem

If someone could make sence of this for me pls that would be greatly appreciated because honestly it makes no sence in my mind maybe I'm wrong and they are all different or there is a huge difference or they arnt perscribe doe certain things if I am my bad pls correct me
Thanks once again I appreciate it ?
 
I imagine that why people get perscribed different medications for the same issue is down to the patients seeing different doctors, these doctors may have different understands of the drugs or representatives have convinced them to prescribe one more than the other, there are many possible variables to your question.

Aso for the second question Vicodin, zydone etc are brand names made up by the pharmaceutical company that makes them .
 
1. Doctors are human beings, not robots.
2. Because different companies call their products different things.
 
Thanks mindlessbilly that does make sence I appreciate ur help

Transform there's no need to be rude about it it's a question I wasn't ranting or anything it was a legitimate Question
 
Every person is different, and you would not give same medication to a 80 year old lady as you would for 23 year old man ....

Plus, if every doctor gave exactly the same meds for each scenario, then there would be no evolution of medical practice.. If everyone does the same thing all the time, nothing would ever get better
 
Different narcotics have slightly different properties, even though most of them (opioids) have the same mechanism of action. Each one of them has their own specific duration of action, meaning that some pain meds can be used for breakthrough pain whereas others are more suitable for around-the-clock pain relief. Some of them have less abuse potential than others (e.g. buprenorphine). Some are better tolerated than others (e.g. oxycodone). Many of them are metabolised by different enzymes, meaning suitable meds can be given to someone who has, say, a defunct version of an enzyme. Some opioids can be taken better orally (e.g. codeine) whereas others need to be administered intravenously to be effective (e.g. morphine).

There are other pain meds which have different mechanisms of action (e.g gabapentinoids) which can be used if one reacts badly to opioids in general (e.g. excess histamine release). These meds can also be used in conjunction with opioids to lower the dosages of both drugs required for analgesia. For example, small doses of ketamine potentiate the analgesic effects of morphine, and was used in one patient who needed to take high doses of morphine for pain relief, which resulted in severe side effects (I can't find the source to this, but it was posted on BL recently).

In general, people are different. Also, people have different analgesic needs and thus there are different medicines for each situation.
 
Alien47 said:
Thanks mindlessbilly that does make sence I appreciate ur help

Transform there's no need to be rude about it it's a question I wasn't ranting or anything it was a legitimate Question
Click to expand...

I dont think Transform was being rude, just abrupt. As to his second answer, I will elaborate. Vicodin, Norco, Xodol etc. all contain hydrocodone and acetaminophen. One reason one may get Vicodin and another hydrocodone is because they are considered equivalent and pharmacists can subsitute (most states require this actually) without consulting the prescriber if they or the patient do not specifically note the brand name must be dispensed. To complicate the matter slightly, Abbvie, the maker of Vicodin, is now pricing and promoting Vicodin as a generic so some pharmacies may choose Vicodin as their generic hydrocodone/APAP product if the price is cheaper than others.

In the USA, a product doesnt need to be better, just different in order for it to win approval. So, since hydrocodone/APAP products have consistently been at the top of the list of most frequently prescribed drugs, different companies tried to make slight changes in the amount of either hydrocodone or more frequently APAP to get a new product approved and on the market to capture a share of the market.
 
actually here inn europe they do.

It's called morphine.
 
Because everyone's different, we're not all made the same, one of those four people would most probably have a bad reaction if all treated with the same medication. On prescribing meds, the dr will take into account, your age, gender, bmi, medicines that your already on, your past record of abuse/tolerance, etc. My GP hates prescribing any opiates but would rather prescribe morphine ER than codeine, each dr will always have their own drug of choice but they are also aware it doesn't work for everyone.
 
Where I live, I've actually had this,- well the opposite convo with my PM.

Why is oxycodone always prescribed first? Then oxycontin? He says he's often wondered the same thing but doesn't know why.

Rtp
 
funny question, since oxycodon (chemical name) is the same as Oxycontin (brand name)...
 
Why is oxycodone always prescribed first? Then oxycontin?
Click to expand...

Dr's prefer to prescribe an IR med first to be sure it works acceptably before switching you to a time released version... no point in giving you XR medication that doesnt work

and they know that the continuous release shit is way more abusable/resalable
 
I find it funny when people confuse brand names with trivial names of drugs...

Different strokes for different folks I guess is the answer. People are different, so are drugs, so it's a matter of finding a match. Some opioids are good because they're weak or have a ceiling (codeine) in the case of weak pain, some are good for breakthrough pain, some, with a longer half-life or similar, are better for chronic pain and/or stronger pain. Honestly, though, I sometimes wonder the same thing. Whether we really do need so many different kinds of opioids or a few would actually suffice.
 
I read case reports from Massachusetts General (the New England Journal of Medicine case reports series) and work in a clinic that has a practicing pain management professional, and getting rid of the extra meds that seem unnecessary would hinder things. There are many instances where someone will not respond to thebaine derived opioids like hydro/oxycodone, hydro/oxymorphone and so have to be take true opiates like morphine or codeine, or fentanyl/pethidine analogs. Sometimes different meds in the same class like oxycodone and hydrocodone have wildly different efficacy and side effects in the same patient. As stated a few times above, there is also the considerations of potency, possible ROAs, half-life, addiction potential, and side-effect profiles that all contribute. Different names for the same product have no effect though - and from what I have seen, brand names are typically regional and pharmacy dependent based on what is stocked in that area/pharmacy.

(An example from the journal mentioned above - a woman with small cell lung cancer tried virtually every pain med on the planet for intractable cancer related pain, and the only thing that worked was a combination of Vicodin and Ketorlac, with IV morphine and hydromorphone causing dramatic increases in pain - not what you would usually expect)
 
Research over the last ten years has found that there are particular genetic markers that influence how you respond to different opiate medications. Different people have really different responses to each drug. As well as doctors having their own prescribing preferences, they often have to try a few different medications before they settle on one that works for an individual.
 
So, back to me & my PM wondering why oxycodone/Contin is prescribed so routinely,- It's just the benchmark drug here.

MS Contin, durogesic, hydro morph, etc come later.

My hand is suddenly fucked, can't type it's purely numb on my right side.
 
Neuropathic or viceral pain. Ladder of analgesia, response, dose-response, personal experience of doctor, comorbidity (or comorbidities) of patient, legal implications (this last is the DEA spotting a doctor who is giving MORE than average. I have a friend who is a US Lawyer who defends these doctors. She's said that 95% of the time it's because it's an area with a higher average age - retirement communities. Stuff the DEA could so easily check.... still, they want to stay in a job so she's got known as the 'go to' legal specialist in the field; word of mouth.
 
You must log in or register to reply here.
Top