ADVANCED PHARMACOLOGY
FUNDAMENTALS CERTIFICATION
EVALUATION 2026 EXAM QUESTIONS AND
SOLUTIONS
◉ Pure opioid agonist.
Answer: activate opioid receptors in brain resulting in opioid effect
◉ examples of pure opioid agonist.
Answer: morphine, methadone, fentanyl, heroin, oxycodone,
hydrocodone, opium
◉ pure opioids produce what effects?.
Answer: analgesia, euphoria, sedation, respiratory depression,
physical dependence, constipation
◉ prototype for strong opioid agonist.
Answer: morphine
◉ moderate to strong opioid agonist prototype.
Answer: codeine
,◉ A person who is depend on a pure opioid agonist should NEVER
receive an opioid agonist antagonist.
Answer: true
◉ opioid agonist-antagonist.
Answer: used to treat opioid dependence and pain. They work by
reducing the affects of withdrawal symptoms and affecting pain
sensors.
◉ examples of opioid agonist-antagonist.
Answer: Buprenorphine, Pentazocine, Butorphanol, Nalbuphine
◉ pure opioid antagonist.
Answer: reverse and blocks opioid effects
◉ example opioid antagonist.
Answer: naloxone
◉ When to refer a patient to a pain specialist?.
Answer: required for patients who take 120 mme per day of
morphine milligram equivalents
,◉ What is used to calculate pt's overdose risk?.
Answer: total morphine milligram equivalent (MME) per day to help
assess the patient's overdose risk. If it is high (≥50 MME/day and
especially ≥90 MME/day)
Calculate total daily dose: 1. daily amount of each opioid that patient
takes 2. convert to MME, multiply dose for each opioid by conversion
factor 3. add them together
◉ What is MME and when to use?.
Answer: morphine milligram equivalent, represents the potency of
an opioid in comparison to morphine, used to identify opioid
prescription burden of a person
◉ What is the prescription drug monitoring program?.
Answer: electronic databases enable providers to access information
regarding a patient's prescription history of controlled substances.
Nearly all states have implemented PDMPs, and some states require
providers to check the PDMP before prescribing controlled
substances.
◉ When should PDMP be used?.
Answer: anytime a controlled substance is prescribed, refilled, or
filled
, ◉ Why is PDMP important?.
Answer: identify those at risk for overdose
◉ Assess someone for possible drug diversion?.
Answer: Urine test at least yearly
PDMP routinely
◉ How does renal and hepatic function impact medication levels in
body?.
Answer: Patients with renal or hepatic insufficiency can experience
greater peak effect and longer duration of action for medications,
thereby reducing the dose at which respiratory depression and
overdose may occur. Similarly, for patients ages 65 years and older,
reduced renal function and medication clearance due to age can
result in a smaller therapeutic window between safe dosages and
dosages associated with respiratory depression and overdose.
◉ How do elderly metabolize differently than younger people?.
Answer: Older adults metabolize opioids slowly and therefore
require lower doses than younger adults.
◉ When should naloxone be prescribed?.
Answer: with every opioid prescription
FUNDAMENTALS CERTIFICATION
EVALUATION 2026 EXAM QUESTIONS AND
SOLUTIONS
◉ Pure opioid agonist.
Answer: activate opioid receptors in brain resulting in opioid effect
◉ examples of pure opioid agonist.
Answer: morphine, methadone, fentanyl, heroin, oxycodone,
hydrocodone, opium
◉ pure opioids produce what effects?.
Answer: analgesia, euphoria, sedation, respiratory depression,
physical dependence, constipation
◉ prototype for strong opioid agonist.
Answer: morphine
◉ moderate to strong opioid agonist prototype.
Answer: codeine
,◉ A person who is depend on a pure opioid agonist should NEVER
receive an opioid agonist antagonist.
Answer: true
◉ opioid agonist-antagonist.
Answer: used to treat opioid dependence and pain. They work by
reducing the affects of withdrawal symptoms and affecting pain
sensors.
◉ examples of opioid agonist-antagonist.
Answer: Buprenorphine, Pentazocine, Butorphanol, Nalbuphine
◉ pure opioid antagonist.
Answer: reverse and blocks opioid effects
◉ example opioid antagonist.
Answer: naloxone
◉ When to refer a patient to a pain specialist?.
Answer: required for patients who take 120 mme per day of
morphine milligram equivalents
,◉ What is used to calculate pt's overdose risk?.
Answer: total morphine milligram equivalent (MME) per day to help
assess the patient's overdose risk. If it is high (≥50 MME/day and
especially ≥90 MME/day)
Calculate total daily dose: 1. daily amount of each opioid that patient
takes 2. convert to MME, multiply dose for each opioid by conversion
factor 3. add them together
◉ What is MME and when to use?.
Answer: morphine milligram equivalent, represents the potency of
an opioid in comparison to morphine, used to identify opioid
prescription burden of a person
◉ What is the prescription drug monitoring program?.
Answer: electronic databases enable providers to access information
regarding a patient's prescription history of controlled substances.
Nearly all states have implemented PDMPs, and some states require
providers to check the PDMP before prescribing controlled
substances.
◉ When should PDMP be used?.
Answer: anytime a controlled substance is prescribed, refilled, or
filled
, ◉ Why is PDMP important?.
Answer: identify those at risk for overdose
◉ Assess someone for possible drug diversion?.
Answer: Urine test at least yearly
PDMP routinely
◉ How does renal and hepatic function impact medication levels in
body?.
Answer: Patients with renal or hepatic insufficiency can experience
greater peak effect and longer duration of action for medications,
thereby reducing the dose at which respiratory depression and
overdose may occur. Similarly, for patients ages 65 years and older,
reduced renal function and medication clearance due to age can
result in a smaller therapeutic window between safe dosages and
dosages associated with respiratory depression and overdose.
◉ How do elderly metabolize differently than younger people?.
Answer: Older adults metabolize opioids slowly and therefore
require lower doses than younger adults.
◉ When should naloxone be prescribed?.
Answer: with every opioid prescription
