Midterm Exam: NR565/ NR 565 Advanced
Pharmacology Care of the Fundamentals
Exam | Questions and Verified Answers
(2024/ 2025 Update)- Chamberlain
QUESTION
How does strength of fentanyl compare to morphine
Answer:
high milligram potency (about 100 times that of morphine)
QUESTION
through what system is fentanyl metabolized?
Answer:
CYP34A (isoenzyme of CYP450), levels of fentanyl can be increased by CYP34A inhibitors
QUESTION
What is methadone used to treat?
Answer:
relieve pain and treat opioid addiction
QUESTION
For what level of pain is codeine prescribed?
Answer:
mild to moderate
QUESTION
What does 10% of codeine convert to/black box warning
,@PROFNOVIEK
Answer:
10% of each dose of codeine undergoes conversion to morphine, the active form of codeine (led
to death in children and toxicity in infants through breast milk)
QUESTION
Black box warning for hydrocodone
Answer:
products that contain Tylenol are associated with hepatotoxicity
QUESTION
Black box warning opioids, fentanyl, oxycodone, hydromorphone, oxymorphone
Answer:
respiratory depression
QUESTION
black box warning for methadone
Answer:
prolong QT interval, fatal dysrhythmias
QUESTION
Do opioid agonist-antagonist have high or low potential for abuse?
Answer:
low - when compared with opioid agonists
QUESTION
If you switch a patient from oxycodone to buprenorphine quickly what may we expect to see?
Answer:
If given to a patient who is physically dependent on a pure agonist, there drugs can precipitate
withdrawal
,@PROFNOVIEK
QUESTION
What level of pain is tramadol approved for
Answer:
moderate to moderately severe
QUESTION
What schedule is tramadol classified as?
Answer:
schedule IV
QUESTION
What population should tramadol be AVOIDED in?
Answer:
pt's with epilepsy, neurologic disorders, elderly
QUESTION
What drugs should be avoided for patients taking tramadol?
Answer:
CNS depressants (benzo, alcohol), MAOI, SSRI, serotonin and norepinephrine reuptake
inhibitors, tricyclic antidepressants, triptans
QUESTION
What government branch declared the opioid crisis a public health emergency?
Answer:
Health and Human Services (HHS)
QUESTION
, @PROFNOVIEK
what are the top 5 priorities of HHS?
Answer:
Improving access to treatment and recovery services
Promoting use of overdose-reversing drugs
Strengthening our understanding of the epidemic through better public health surveillance
Providing support for cutting edge research on pain and addiction
Advancing better practices for pain management
QUESTION
What were provisions made to the guidelines for prescribing opioids to non-cancer patients?
Answer:
Using opioids only after non-opioid analgesics or more conservative methods have failed
Discussing the benefits and risks for long term opioids with patient
When possible, one prescriber, one pharmacy
Ensuring comprehensive follow up to assess efficacy and side effects of treatment and monitor
for signs of opioid abuse
Stopping opioids after an attempt at opioid rotation had produced inadequate benefits
Fully documenting the entire process
QUESTION
When prescribing opioids should patient be initially started on IR or ER?
Answer:
IR- lowest dose for shortest amount of time
QUESTION
How are patients initially exposed to opioids?
Answer:
either recreationally (illicitly) or in context of pain management in medical setting
QUESTION
Which group of professionals are at greater risk for abusing?
Answer: