BOARD CERTIFICATION EXAM STUDY GUIDES Lower Extremity Trauma
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Posted on May 10, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
MAY 8 – 14th, 2022
By Staff Reporters
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Prioritizing your health – both physical and mental – has never been more important. Over the past few years, many women have put off taking care of their general health and wellness needs. They have adjusted their daily routines, including the way they connect with family and friends. The combination has led to serious health problems for some women.
Posted on May 10, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
By Staff Reporters
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Bitcoinis now almost 50% off its all-time high. If bitcoin is a store of value, it certainly hasn’t proven itself yet. With bitcoin’s price falling below $30,000 for the first time since July 2021, at least 40% of bitcoin investors are underwater.
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Markets: The S&P fell below 4,000 points for the first time in more than a year as inflation concerns trampled a day down on Wall Street. Big Tech companies lost more than $1 trillion in market value over the past three trading sessions alone.
Posted on May 10, 2022 by Dr. David Edward Marcinko MBA MEd CMP™
Altered and Poorly Written Rx for Vicodin
By Dr. David Edward Marcinko MBA
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Poorly-written Rx for vicodin
Drug: Rx Vicodin
Disp: # 10
Sig: Take I, as needed for pain.
Refills: 1 2 3 4 or 5
AM2685591
David Edward Marcinko, MBBS DPMMBA
The patient abuser may change drug quantity numbers, copy or remember the doctors’ DEA number, or take extra Rx pads. For this reason, a physician’s Rx pad should contain his/her name, address and telephone number. The doctor’s DEA number should not be pre-printed on the pad, for fear of mis-use.
Example:
Increase the quantity 10, to 100, by adding a zero, so that the additional capsules can be used, sold or bartered with on the street.
Change the directions to take 2 capsules, rather than 1 in order to produce greater euphoria.
Increase the Rx refills, from one to two, by extending the underline, or checking an additional quantity box.
Pre-printed DEA number can be stolen, sold or reused.
Pre-printed (not original) physician signature can be reproduced and widely distributed for more prescriptions.
Altered Rx for vicodin
Drug: Rx Vicodin
Disp: # 100
Sig: Take II, as needed for pain.
Refills: 1 2 3 4 or 5
AM2675591
David Edward Marcinko, MDBBS DPM MBA
The doctor drug addict, or a doc in need of funds, may write for more narcotic agent than needed, and receive the additional pills back from the patient-shill for personal consumption, sell them on the street himself for money, or receive a monetary kickback from the patient-shill.
A pharmacist may also indirectly alter a prescription using the above methods, or simply short-change the patient with fewer narcotic capsules than the prescription intends. This is more difficult to do with pills or tablets in the out patient setting, but easy to do in the in-patient setting when liquid IV drugs are used, by dilution and placing less than the full amount in IV bottles or bags. The harm to patients, of course, may be fatal.
Well-written Rx for vicodin
Drug: Rx Vicodin
Disp: # 10 (ten) capsules
Sig: Take one or two capsules, po, prn pain.
Refills: 1 2 3 4 or 5
AM2685591
David Edward Marcinko, MBBS DPM MBA
Example:
Drug quantity can-not be changed.
Directions can-not be changed. Route of administration (by mouth) indicated.
Rx refills clearly indicated.
Handwritten, not pre-printed, DEA number.
Original physician signature, only.
Doctor Rx prescription abuse foibles are legendary in the DEA and include a Maryland podiatrist who wrote prescriptions for more than 1,235 Mepergan Fortis capsules ostensibly for his wife following minor foot surgery. Or, the Florida physician who prescribed more than 2,150 Vicodin capsules for a patient with whom he was having an extra-marital affair in order that his consort not disclose the fling to his wife. Or, the osteopath from New Jersey who wrote more than 100 narcotic prescriptions every 8 hour day, for more than a year, to any patient standing in a line in front of his office. And, finally the California dentist whose excuse for writing more than 1,845 narcotic tablet prescriptions in a six month period for the same patient was that they would be needed in his next reincarnation. Yes, all of these incidents are laughable if not for their serious consequences to the involved individuals, and society, alike. The bastards!
Fortunately, unlike drug local domestic drug kingpins or international narco-traffickers who ply their trade virtually undetected, these naive white-collared nerds, always get caught by the Drug Enforcement Agency. Their Rx abuse tactics are so amateurish!