What can I do?

[mikhailm]

My stepdad is on the following medications and it is really messing him up: Simvastatin 20 mg(1T QD), Diazepam 10 mg(1T TID), Opana ER 40 mg(1T BID), Atenolol 100 mg(1T QD), Lunesta 3 mg(1T HS), Cymbalta 60 mg(1C BID), Fentora 800 mcg(1T BID PRN), Fentanyl Citrate 1200 mcg(One lollipop QID PRN).

He was OK for a couple of months but yesterday he started acting weird again. Slurred speech(more than usual), lack of balance, forgetfulness, etc.

How can I prevent future episodes from happening? Please I need help.

Michael

[122 Tactical Fighter Group]

Until Doc Jeff gets with  you ....... slow down the diazepam... slow down the fentanyl lollypops (hopefully to less than daily).....  only take the lunesta for insomnia - not nightly for sleep.....    How often daily does he need the diazepam and the fentanyl now?  The opana does the same thing as the fentanyl - - keep those as far apart as you can.  Dont mix the lunesta and the diazepam in too close a dose. They will also mirror each others affects. Sounds like Doc Jeff could help a little more if he knew how many of what and at what times he takes them.  You have a couple that are used for pain and a couple along the nerve pill line. Its either being dosed improperly or the doses are accumulating and causing a problem for him. Only a small possibilty that he is addicted to them.......  but that possibility exists.  Give enough information to adequately answer your question.......

[mikhailm]

Great! Thank you for the advice!

[122 Tactical Fighter Group]

Monitor those meds pretty closely...........If it says take AS NEEDED for pain, sleep,and anxiety do it that way.... Pain and sleep and anxiety do not respond to a clock.  These are biological situations.  Treat them as such.....  Do not try and put them on a time schedule.

[122 Tactical Fighter Group]

No - You never do know so at least keep it in mind as a possibility.  Problem with fusing vertebrae is that it usually only puts more stress on the vertebrae both above and below the one worked on. Soon you have more trouble than you attempted to fix. How big a guy is Dad?  Body size and metabolism could possibly affect the doses. No strokes or anything like that in history are there?

[mikhailm]

Wow! I am not sure if he is addicted to the pain meds but you never now.

[122 Tactical Fighter Group]

Is the medication as listed not controlling the pain?  In my opinion he may be getting too much diazepine and fentanyl. If the evening sleeping pill (lunesta) is given too close to the diazepam there might be problems. The simvastatin and the atenolol and the cymbalta are probably not a problem.......  He may well be getting too much pain medicine. Fentanyl, fentora, and opana are all strong pain meds.....  depending upon metabolism and times of dose the lunesta and the diazepam may be interacting. With a history of 8 surgeries he may be on too much for pain. Doc Jeff will have real solid advice.......  I would think that if the pain is a strong issue with what he is on you need to rethink the game plan.  Dont want to medicate him to a coma........but you dont want him in 24/7 pain either. Tough one here..... Do you have any reason to suspect that he was addicted to the pain meds at anytime?  Sometimes when you take pain meds for a term they will subject you to opiate pain syndrome...... the brain actually tries to convince the body that the body is in pain and requires a dose of narcotics.  

[mikhailm]

My stepdad is in pain all the time due to his back problem. He already had over 8 surgeries on his back and I believe that the surgeon fused his spine. He is in pain all the time from what he tells us.

[mikhailm]

Thank you for the advice. I did list the frequency of use in parenthesis after each drug.

Simvastatin 20 - takes 1 tablet daily
Diazepam 10 - 1 tablet 3 times daily
Opana Er 40 - 1 tablet 2 times a day
Atenolol 100 - 1 tablet daily
Lunesta 3 - 1 at bedtime
Cymbalta 60 - twice a day
Fentora - twice a day
Fentanyl - 4 times a day.

Unfortunately I do not know at what times he takes the medicine.