| MOST RECENT EXAM 2026 ACTUAL COMPREHENSIVE
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Use of opioids and these other medications should be avoided
and why? - ANSWER-respiratory depression with other drugs
with CNS depressant action
CNS depressants
barbiturates
benzo alcohol
general
aesthetics anti-
histamines
phenothiazine
anticholinergic
drugs atropine
tricyclic antidepressants (constipation and urinary retention)
what is the classic triad of symptoms for an opioid overdose? -
ANSWER-MAOI
,(hyperpyrexia
coma)
coma, resp depression,
pinpoint pupuls
How does strength of fentanyl compare to morphine -
ANSWER-high milligram
potency (about 100 times that of
morphine)
through what system is fentanyl metabolized? - ANSWER-
CYP34A (isoenzyme
of CYP450), levels of fentanyl can be increased by
CYP34A inhibitors
What is methadone used to treat? - ANSWER-relieve pain
and treat opioid
addiction
For what level of pain is codeine prescribed? - ANSWER-mild to
moderate
What does 10% of codeine convert to/black box warning -
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)
Black box warning for hydrocodone - ANSWER-products that
contain Tylenol
,are associated with
hepatotoxicity
Black box warning opioids, fentanyl, oxycodone,
hydromorphone, oxymorphone
- ANSWER-respiratory
depression
black box warning for methadone - ANSWER-prolong QT
interval, fatal
dysrhythmias
Do opioid agonist-antagonist have high or low potential for
abuse? - ANSWER-
low - when compared with opioid
agonists
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
What level of pain is tramadol approved for - ANSWER-moderate
to moderately
severe
What schedule is tramadol classified as? - ANSWER-schedule
IV
, What population should tramadol be AVOIDED in? -
ANSWER-pt's with
epilepsy, neurologic
disorders, elderly
What drugs should be avoided for patients taking tramadol? -
ANSWER-CNS
depressants (benzo, alcohol), MAOI, SSRI, serotonin and
norepinephrine
reuptake inhibitors, tricyclic
antidepressants, triptans
What government branch declared the opioid crisis a public
health emergency?
- ANSWER-Health and Human
Services (HHS)
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