thinkertdm Posted October 27, 2020 Share Posted October 27, 2020 Does anyone have a good chart of nsaids, cox selectivity, and maybe even morphine equivalency? I read somewhere that 60 mg of toradol was equivalent to 10 mg of morphine. analgesia-wise. I'd ask the team pharmacist but they would just google it. Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 27, 2020 Moderator Share Posted October 27, 2020 I believe there is a chart in Tarascon. As an aside, the current trend is to never use more than 15 mg of toradol by any route as studies have shown 60 mg works no better than 10 mg , but causes a lot more kidney and GI issues. 2 2 Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted October 28, 2020 Moderator Share Posted October 28, 2020 Depends. Ibu equivocal to oxycodone in one stUdy on dental pain Quote Link to comment Share on other sites More sharing options...
dfw6er Posted October 29, 2020 Share Posted October 29, 2020 On 10/27/2020 at 7:24 PM, EMEDPA said: I believe there is a chart in Tarascon. As an aside, the current trend is to never use more than 15 mg of toradol by any route as studies have shown 60 mg works no better than 10 mg , but causes a lot more kidney and GI issues. Yup... data shows the therapeutic ceiling for IV toradol is 10mg. 2 Quote Link to comment Share on other sites More sharing options...
kittryn Posted October 29, 2020 Share Posted October 29, 2020 "I'd ask the team pharmacist but they would just google it". Why don't you just google it? Quote Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted October 29, 2020 Share Posted October 29, 2020 (edited) It isn’t about efficacy. It’s about which dosing/medication generates the greatest in-house revenue for the employer. Years ago in EM once I saw the results for po ibuprofen compared to IV Toradol, well I’ll let you guess which of the two I started to prescribe more often. This was meant to imply that I gave up on the Toradol. Edited October 30, 2020 by GetMeOuttaThisMess Addition Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 29, 2020 Moderator Share Posted October 29, 2020 1 hour ago, GetMeOuttaThisMess said: It isn’t about efficacy. It’s about which dosing/medication generates the greatest in-house revenue for the employer. Years ago in EM once I saw the results for po ibuprofen compared to IV Toradol, well I’ll let you guess which of the two I started to prescribe more often. There is a huge mark up on toradol. I took a family member into an Urgent care(not even an ER) for a bad h/a not responding to triptans, compazine, etc. They got IM toradol only. The bill? $800. I asked a pharmacist what the cost of a 60 mg vial of toradol is. $12. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted October 29, 2020 Share Posted October 29, 2020 Wellll....part of it is the smoke-and-mirrors magic of medicine. Anything prescription administered with a needle is WAYYYYYY better than anything over the counter..... idiot. Sometimes you selling the sizzle instead of the steak. It's sad we even have to think that way sometimes. Quote Link to comment Share on other sites More sharing options...
CAAdmission Posted October 29, 2020 Share Posted October 29, 2020 1 hour ago, EMEDPA said: The bill? $800. I asked a pharmacist what the cost of a 60 mg vial of toradol is. $12. You're forgetting the markup for the syringe, the needle, the prep pad and the bandaid. That's probably $700 right there. Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted October 30, 2020 Administrator Share Posted October 30, 2020 8 hours ago, EMEDPA said: I asked a pharmacist what the cost of a 60 mg vial of toradol is. $12. That's the retail price. I think it was more like $50-75 for a pallet of 25, 60 mg vials, but I haven't ordered pharmaceuticals for a clinic in a while. Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted October 30, 2020 Share Posted October 30, 2020 I remember a UC I worked for telling me to stop giving decadron PO because they wanted to be able to bill the $35 for an IM injection. 1 1 Quote Link to comment Share on other sites More sharing options...
dfw6er Posted October 30, 2020 Share Posted October 30, 2020 13 hours ago, ohiovolffemtp said: I remember a UC I worked for telling me to stop giving decadron PO because they wanted to be able to bill the $35 for an IM injection. We'd withdraw 0.6mg/kg of decadron from the vial into a syringe, then mix with apple juice and have kids drink if for croup exacerbations in our ER. Worked great and admin never gave us a hard time about it either. 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted October 31, 2020 Moderator Share Posted October 31, 2020 8 hours ago, dfw6er said: We'd withdraw 0.6mg/kg of decadron from the vial into a syringe, then mix with apple juice and have kids drink if for croup exacerbations in our ER. Worked great and admin never gave us a hard time about it either. same, but generally in ibu 100/5 as they have fevers too. 1 1 Quote Link to comment Share on other sites More sharing options...
dfw6er Posted November 1, 2020 Share Posted November 1, 2020 22 hours ago, EMEDPA said: same, but generally in ibu 100/5 as they have fevers too. That's actually a really good idea. I'm stealing that. 1 Quote Link to comment Share on other sites More sharing options...
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