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NP Dr. Young

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NP Dr. Young last won the day on November 18 2018

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  1. Thanks for the question and thanks for the links!! NP Dr. Young
  2. Right, the level is problematic for me. I have never seen a lab level of 100,000 ng/ml before and, at any rate, can't see how 300 mg tid would ever lead to such a range. The patient is negative for all other drugs. I'm wondering how others would approach the result.
  3. Hi All I ordered a gabapentin level from Quest Dx as part of my routine new patient lab orders. The patient is on 300 mg tid from another provider. The result came back out of range at 100,000 ng/ml. The reference range is <1000 ng/ml. I called the lab to discuss the validity and reliability of the result but have not heard back from them. My own research suggests that toxicity from gabapentin can occur at much lower levels but that some patients require up to 80,000 ng/ml for relief. I then called the manufacturer, Amneal, to inquire about expected ranges of levels from various daily doses of gabapentin and was told that they don’t know. Any thoughts or suggestions? Thank you. NP Dr. Olivia Young, FPMHNP-BC
  4. Hi, While looking for information about telehealth MAT, I ran across SAMHSA's statement on the correct terminology for it. According to SAMHSA: "Definitions of telemedicine and telehealth vary across jurisdictions. SAMHSA uses the federal Medicaid definition of telemedicine: Telemedicine seeks to improve a patient's health by permitting two-way, real time interactive communication between the patient, and the physician or practitioner at the distant site. This electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment...[Medicaid] does not recognize telemedicine as a distinct service...By contrast, telehealth is usually used as a broader term. Telehealth typically includes not only telemedicine but also other forms of telecommunication, including asynchronous or “store and forward” systems, which transfer a patient’s data or images for a physician or practitioner at another site to access at a later time. With these systems, the patient and provider do not have to be present at the same time" https://www.samhsa.gov/section-223/care-coordination/telehealth-telemedicine. Therefore, I have added the following tags: "telehealth," "telehealth MAT," and "MAT telehealth" to compensate for my initial, somewhat sloppy use, of the term "telemat." Best, NP Dr. Olivia Young, FPMHNP-BC
  5. Currently, I am a locum tenens and telehealth nurse practitioner, I have active APRN licenses in the states of AZ, MN, IA, OR, and WA. I am also licensed in MO but do not practice there. My XDea license is currently assigned to MN. My locums work entails onsite and telepsych work. I am trying to set-up my own private wellness-oriented medication assisted treatment (MAT) and addictions recovery, pain management telehealth practice which also includes co-occurring disorders and psychotherapy, I'm an experienced practitioner in each of the areas separately. and have combined telepsych with most of them. But, I have never combined the practice of MAT or pain management with telehealth. In addition, my experience with MAT was during a two semester 2012-2013 clinical in a hospital-based substance use Missouri treatment facility under the preceptorship of a seasoned buprenorphrine psychiatrist. Hence, I would like guidance in adding a state of the art telemat component to my practice.
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