ADVANCED PHARM FINAL EXAM
KEY CONCEPTS AND REVISION
NOTES
◉ One of the main drug classes used to treat acute pain is NSAIDs.
They are used because:
1. They have less risk for liver damage than acetaminophen.
2. Inflammation is a common cause of acute pain.
3. They have minimal GI irritation.
4. Regulation of blood flow to the kidney is not affected by these
drugs.
Answer: 2. Inflammation is a common cause of acute pain.
◉ Opiates are used mainly to treat moderate to severe pain. Which
of the following is NOT true about these drugs?
1. All opiates are scheduled drugs which require a DEA license to
prescribe.
2. Opiates stimulate only mu receptors for the control of pain.
3. Most of the adverse effects of opiates are related to mu receptor
stimulation.
4. Naloxone is an antagonist to opiates.
Answer: 2. Opiates stimulate only mu receptors for the control of
pain.
,◉ If interventions to resolve the cause of pain (e.g., rest, ice,
compression, and elevation) are insufficient, pain medications are
given based on the severity of pain. Drugs are given in which order
of use?
1. NSAIDs, opiates, corticosteroids
2. Low-dose opiates, salicylates, increased dose of opiates
3. Opiates, non-opiates, increased dose of non-opiate
4. Non-opiate, increased dose of non-opiate, opiate
Answer: 4. Non-opiate, increased dose of non-opiate, opiate
◉ Pathological similarities and differences between acute pain and
chronic pain include:
1. Both have decreased levels of endorphins.
2. Chronic pain has a predominance of C-neuron stimulation.
3. Acute pain is most commonly associated with irritation of
peripheral nerves.
4. Acute pain is diffuse and hard to localize.
Answer: 2. Chronic pain has a predominance of C-neuron
stimulation.
◉ A treatment plan for management of chronic pain should include:
1. Negotiation with the patient to set personal goals for pain
management
2. Discussion of ways to improve sleep and stress
, 3. An exercise program to improve function and fitness
4. All of the above
Answer: 4. All of the above
◉ Chronic pain is a complex problem. Some specific strategies to
deal with it include:
1. Telling the patient to "let pain be your guide" to using treatment
therapies
2. Prescribing pain medication on a "PRN" basis to keep down the
amount used
3. Scheduling return visits on a regular basis rather than waiting for
poor pain control to drive the need for an appointment
4. All of the above
Answer: 3. Scheduling return visits on a regular basis rather than
waiting for poor pain control to drive the need for an appointment
◉ Chemical dependency assessment is integral to the initial
assessment of chronic pain. Which of the following raises a "red flag"
about potential chemical dependency?
1. Use of more than one drug to treat the pain
2. Multiple times when prescriptions are lost with requests to refill
3. Preferences for treatments that include alternative medicines
4. Presence of a family member who has abused drugs
Answer: 2. Multiple times when prescriptions are lost with requests
to refill
KEY CONCEPTS AND REVISION
NOTES
◉ One of the main drug classes used to treat acute pain is NSAIDs.
They are used because:
1. They have less risk for liver damage than acetaminophen.
2. Inflammation is a common cause of acute pain.
3. They have minimal GI irritation.
4. Regulation of blood flow to the kidney is not affected by these
drugs.
Answer: 2. Inflammation is a common cause of acute pain.
◉ Opiates are used mainly to treat moderate to severe pain. Which
of the following is NOT true about these drugs?
1. All opiates are scheduled drugs which require a DEA license to
prescribe.
2. Opiates stimulate only mu receptors for the control of pain.
3. Most of the adverse effects of opiates are related to mu receptor
stimulation.
4. Naloxone is an antagonist to opiates.
Answer: 2. Opiates stimulate only mu receptors for the control of
pain.
,◉ If interventions to resolve the cause of pain (e.g., rest, ice,
compression, and elevation) are insufficient, pain medications are
given based on the severity of pain. Drugs are given in which order
of use?
1. NSAIDs, opiates, corticosteroids
2. Low-dose opiates, salicylates, increased dose of opiates
3. Opiates, non-opiates, increased dose of non-opiate
4. Non-opiate, increased dose of non-opiate, opiate
Answer: 4. Non-opiate, increased dose of non-opiate, opiate
◉ Pathological similarities and differences between acute pain and
chronic pain include:
1. Both have decreased levels of endorphins.
2. Chronic pain has a predominance of C-neuron stimulation.
3. Acute pain is most commonly associated with irritation of
peripheral nerves.
4. Acute pain is diffuse and hard to localize.
Answer: 2. Chronic pain has a predominance of C-neuron
stimulation.
◉ A treatment plan for management of chronic pain should include:
1. Negotiation with the patient to set personal goals for pain
management
2. Discussion of ways to improve sleep and stress
, 3. An exercise program to improve function and fitness
4. All of the above
Answer: 4. All of the above
◉ Chronic pain is a complex problem. Some specific strategies to
deal with it include:
1. Telling the patient to "let pain be your guide" to using treatment
therapies
2. Prescribing pain medication on a "PRN" basis to keep down the
amount used
3. Scheduling return visits on a regular basis rather than waiting for
poor pain control to drive the need for an appointment
4. All of the above
Answer: 3. Scheduling return visits on a regular basis rather than
waiting for poor pain control to drive the need for an appointment
◉ Chemical dependency assessment is integral to the initial
assessment of chronic pain. Which of the following raises a "red flag"
about potential chemical dependency?
1. Use of more than one drug to treat the pain
2. Multiple times when prescriptions are lost with requests to refill
3. Preferences for treatments that include alternative medicines
4. Presence of a family member who has abused drugs
Answer: 2. Multiple times when prescriptions are lost with requests
to refill
