Should a Doctor be able to Prescribe....

[Iowa Roo Mom]

Here it is folks, the burning question in the ICCU tonight..... What do you think?!? A few points that have been brought up...

Yes, you can buy them OTC here in Iowa, but you must be 18. Here is a scenario:

The scenario is a 16 year old is admitted for a tylenol overdose. 3 days later he is asking for a nicotine patch. He has been alert and oriented for AT LEAST 2 days and has never asked before. He shows no clinical S/S of withdrawl. What do you do?

 

[Crusty McPottydoodle]

If the kid is addicted and wants to quit - heck yes.

 

[BattleChickens]

Quote:
agreed.

 

[FrenchHen]

Aren't they available OTC?

 

[ERnoleGuy]

Yes, but it is also a question of 'why is the kid in the ICCU?' And will the nicotine harm or better the situation. People who smoke often go weeks without nicotine while in the ICU or such after being in a horrible trauma or the like. It's not going to kill someone to go without nicotine. Especially if they are in the ICCU. Medicine is all about risk/benefit ratio. There is most certainly a greater risk to the patient to HAVE a nicotine patch than to go without it for the time being. If the kid is having withdrawals, treat the withdrawals via other means.

Now, outside of the critical care setting, and when a doctor is not in the picture... that is a parent choice in my opinion. Like mentioned, they are OTC.

 

[saddina]

1. Can he buy them OTC at 16, or will he be carded for it?

2. Is the prescription needed so insurance covers the costs instead? (example, you can buy lactaid OTC, but my reactions to milk are violent enough for ER visits, so doc prescribes the ultra high dose, which is way too costly for me to afford daily on my own).

 

[gypsy2621]

If he isn't exhibiting clinical signs of withdrawal I say No
nicotine patches have side effects that shouldn't have to be dealt with by a 16 year old.
on the same hand why isn't the parent aware the child is smoking?
even for a smoker themselves they should be able to smell the after smells. and the excuse of "oh I was with friends who smoke doesn't cut it. if you smell it the child is smoking."

After 24 hours in ICU he would be showing symptoms of withdrawal.

 

[saddina]

Quote:
Your missing door #3, parent is a smoker, doesn't see anything wrong with smoking, buys smokes for the kid, and would see JR trying to quit as an insult to them. I can think of more than 1 parent who not only let thier kids smoke, but took it personally when thier kid wanted to quit smoking.

 

[gypsy2621]

Quote:
Your missing door #3, parent is a smoker, doesn't see anything wrong with smoking, buys smokes for the kid, and would see JR trying to quit as an insult to them. I can think of more than 1 parent who not only let thier kids smoke, but took it personally when thier kid wanted to quit smoking.

I went back and looked and didnt see any reference to parents smoking and it being an issue with the child quitting?

personally any parent who buys cigarettes for a child needs to be fined and jail time, or taken out behind a building and get severely beaten about the head and shoulders.
thats just wrong wrong. parents should be encouraging best behavior not pushing such a bad one.

I smoke but it is not something I want my children to do.

 

[Sitka]

I'm wondering if the kid wants the "high" of the nicotine delivered via the patch. This is a very interesting question. I voted "No" but am on the fence. Even if the kid is a smoker, it seems this is an issue for his family doctor, not the ICU. Also, since the patch can have side effects and is not medically necessary, there would be medico-legal liability issues and the Dr. / hospital might be reluctant.

[edit typo]