EMRAP 2016 February Canadian Edition

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John C. -

Canadian Edition on Tramacet
In the February 2016 Canadian Edition, Dr. Rosenberg mentioned that he had noted that Tramacet had been creeping into Medical Directives in his institution and he believed it had to do with a Nursing College resistance to have Nurses initiate Narcotics. The actual reason is the Narcotic Control Act of Canada which makes it illegal for anyone but Physicians and Dentists to prescribe Narcotics and makes this a non-delegatable act. Thus Tramacet is employed as it is not covered under the Act. I suggest both a short term and a longer term fix. Short Term, convince your Medical Advisory Group to replace Tramacet with pain does Ketamine. Longer term - lobby the federal Government to ammend the Narcotic Control Act to both allow the prescription of at least some Narcotics by NP's and PA's and to make the prescription of these drugs delegatable so they can be included in Medical Directives.
John Cunningham, MPAS, CCPA
Physician Assistant (Canadian)

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