NRl 565/l NR565l Midterml Exam:l
Advancedl Pharmacologyl Fundamentalsl
Guidel (Latestl 2026/l 2027l Update)l |l Qsl
&l As|l Gradel A|l 100%l Correctl (Verifiedl
Answers)-l Chamberlain
QUESTION
Fentanyll Overdosel Risk
Answer:
·l Veryl strong,l veryl potent
ol Aboutl 100l timesl morel potentl thanl morphine
QUESTION
Methadonel QTl Prolongation
Answer:
·l Repeatedl dosingl causesl accumulationl ofl thisl drug.l Hasl longl durationl ofl action
·l Canl causel prolongedl QT
·l Consultl withl al painl specialistl andl titratel methadone
·l Methadonel isl usedl tol relievel painl andl treatl opioidl addiction
·l Receivel ECGl priorl tol treatments,l 30l daysl afterl startingl andl annuallyl after
·l Ifl QTl exceedsl 500ms,l stopl methadonel orl reducel dosage
·l Torsadel hasl developedl inl patientsl takingl morel thanl 65mg/day
QUESTION
naloxonel (Narcan)
MOA
Answer:
·l Structurall analogl tol morphine
,·l Actsl asl competitivel antagonistl atl opioidl receptorsl andl blocksl them
·l Reversesl mostl effectsl ofl opioidl agonistsl suchl as:l Respiratoryl depression,l coma,l
euphoria,l andl analgesia
·l Asl nol effectsl onl own
·l IMl adminl startsl inl 2l tol 5l minutesl andl worksl forl hours.l Nol usel inl orall asl firstl passl
effectl eliminatesl drugl immediately
·l Canl sendl ptl intol acutel withdrawal
·l Shortl half-lifel requiresl multiplel adminsl untill opioidl effectl isl gone
QUESTION
Naltrexonel Prescribing
Answer:
notl al controlledl substancel andl doesl notl requirel speciall trainingl orl certification.l
·l AKAl Vivitroll -l purel opioidl antagonistl usedl forl opioidl andl alcoholl abuse
ol Givenl afterl ptl undergoesl opioidl detoxl tol discouragel renewedl opioidl misuse
·l Preventsl euphorial inl opioidl abuse
·l Precipitatesl withdrawal,l usersl mustl bel renderedl opioidl freel priorl tol start
·l Doesl notl preventl opioidl cravingl causingl manyl addictsl tol faill treatment
ol Lessl successfull thanl methadonel whichl blocksl euphorial andl eliminatesl craving
·l Canl causel hepatocellularl injury,l notl forl patientsl withl acutel hepatitisl orl liverl injury
·l Givenl inl twol formulations
ol 50mgl tabletsl forl orall dosing
§l Dosingl schedule:l 100mgl Mondayl andl Wednesday,l 150mgl onl Fridayl orl 50mgl daily
ol ERl suspensionl (380mg/vail)l forl IMl dosingl oncel al month
QUESTION
Opioidl Overdosel Treatment
Answer:
·l Naloxonel isl administeredl forl emergencyl treatmentl ofl knownl orl suspectedl opioidl
overdose.
·l Advisel clientsl andl familyl membersl tol alwaysl calll 911l afterl outpatientl administration.l
Thisl isl becausel thel half-lifel ofl naloxonel isl shorterl thanl thel half-lifel ofl mostl opioids,l
andl whenl naloxonel wearsl off,l overdosel symptomsl willl return.
,QUESTION
opioid-inducedl constipation
Answer:
·l Opioidsl promotel constipationl throughl actionsl inl thel CNSl andl GIl tractl byl activatingl
Ul receptorl inl thel gut,l theyl canl suppressl propulsivel intestinall contractionsl (peristalsis),l
intensifyl nonpropulsivel contractions,l increasel tonel ofl anall sphincter,l inhibitl secretionl ofl
fluidl intol intestinall lumen.
·l Constipationl developsl inl fewl daysl ofl opioidl use
·l Canl causel fecall impaction,l bowell perforation,l rectall tearing,l hemorrhoids
·l GOAL:l producel stooll everyl 1l tol 2l days
ol Nondrugl methods:
§l Physicall activity,l increasedl intakel ofl fiberl andl fluids.l Enemas
ol Prophylacticl drugs:
§l Stimulantl laxativel (senna)l tol counterl reducedl bowell motility
§l Polyethylenel glycoll (osmoticl laxative)
ol Rescuel therapy
§l Ifl prophylactivel isl inadequate
§l Strongl osmoticl laxativel (lactulose,l sodiuml phosphate)
§l Lastl resortl methylnaltrexonel (Relistorl al purel opioidl antagonist),l orall drugl thatl blocksl
Ul receptorsl inl intestine
·l Doesl notl decreasel analgesia,l cannotl enterl CNS,l andl doesl notl precipitatel withdrawal
QUESTION
Tramadoll (Nonl opioidl centrallyl actingl analgesic)
Drugl Interactions
Answer:
·l Analogl ofl codeinel -l approvedl forl moderatel tol moderatelyl severel pain
·l Moderatelyl strong,l lowl riskl forl dependence,l abusel orl respiratoryl depression
ol Treatsl painl throughl opioidl andl nonopioidl mechanisms
§l Weakl agonistl activityl ofl Ul receptor
§l Blocksl NEl andl serotoninl uptake
·l Canl intensifyl CNSl depressantl responsel withl alcoholl andl benzos
·l Canl causel hypertensivel crisisl whenl combinedl withl monoaminel oxidasel inhibitorl
(MAOI)l duel tol inhibitingl NEl uptake
·l Canl causel serotoninl syndromel withl SSRIs.l SNRIs,l NEl reuptakel inhibitors,l tricyclicl
antidepressants,l MAOI'sl andl triptans.
, ·l Urinaryl retentionl andl constipationl whenl usedl withl anticholinergicl drugs
QUESTION
Opioidl Abusel Assessment
Answer:
·l opioidl usel canl leadl tol physicall dependencel inl onlyl 4-8l weeks.
·l Screenl forl riskl factorsl ofl opioidl misusel usingl al tooll likel thel NIDA-Modifiedl ASSIST
Inl thel pastl year,l howl oftenl havel youl usedl thel following:l alcohol,l tobacco,l prescriptionl
orl illegall drugs?
Inl yourl LIFETIME,l whichl ofl thel followingl substancesl havel youl everl used?l Cannabis,l
cocaine,l prescriptionl stimulants,l meth,l inhalants,l sedatives,l hallucinogenics,l streetl opioids,l
prescriptionl opioids,l other?
Inl thel pastl 3l months,l howl oftenl havel youl hadl al strongl desirel orl urgel tol usel (firstl
drug,l secondl drug,l etc)?
Duringl thel pastl 3l months,l howl oftenl hasl yourl usel ofl (firstl drug,l secondl drug,l etc)l ledl
tol health,l social,l legall orl financiall problems?
Duringl thel pastl 3l months,l howl oftenl havel youl failedl tol dol whatl wasl normallyl
expectedl ofl youl becausel ofl yourl usel ofl (firstl drug,l secondl drug,l etc)?
Hasl al friendl orl relativel orl anyonel elsel everl expressedl concernl aboutl yourl usel ofl (firstl
drug,l secondl drug,l etc)?
QUESTION
Opioidl Management
Answer:
·l Limitl numberl ofl opioidsl prescribedl atl onel time
·l Opioidsl arel notl firstl linel treatments
·l Usingl opioidsl onlyl afterl nonopioidl analgesicsl orl morel conservativel methodsl havel
failed
·l Discussingl benefitsl andl riskl ofl long-terml opioidsl withl thel patient
·l Whenl possible,l usingl onlyl onel prescriberl andl onel pharmacy
·l Ensuringl comprehensivel followl upl tol assessl efficacyl andl sidel effectsl ofl treatmentl andl
tol monitorl forl signsl ofl opioidl abuse
·l Stoppingl opioidsl afterl anl attemptl atl opioidl rotationl hasl producedl inadequatel benefit
·l Fullyl documentingl entirel process
Advancedl Pharmacologyl Fundamentalsl
Guidel (Latestl 2026/l 2027l Update)l |l Qsl
&l As|l Gradel A|l 100%l Correctl (Verifiedl
Answers)-l Chamberlain
QUESTION
Fentanyll Overdosel Risk
Answer:
·l Veryl strong,l veryl potent
ol Aboutl 100l timesl morel potentl thanl morphine
QUESTION
Methadonel QTl Prolongation
Answer:
·l Repeatedl dosingl causesl accumulationl ofl thisl drug.l Hasl longl durationl ofl action
·l Canl causel prolongedl QT
·l Consultl withl al painl specialistl andl titratel methadone
·l Methadonel isl usedl tol relievel painl andl treatl opioidl addiction
·l Receivel ECGl priorl tol treatments,l 30l daysl afterl startingl andl annuallyl after
·l Ifl QTl exceedsl 500ms,l stopl methadonel orl reducel dosage
·l Torsadel hasl developedl inl patientsl takingl morel thanl 65mg/day
QUESTION
naloxonel (Narcan)
MOA
Answer:
·l Structurall analogl tol morphine
,·l Actsl asl competitivel antagonistl atl opioidl receptorsl andl blocksl them
·l Reversesl mostl effectsl ofl opioidl agonistsl suchl as:l Respiratoryl depression,l coma,l
euphoria,l andl analgesia
·l Asl nol effectsl onl own
·l IMl adminl startsl inl 2l tol 5l minutesl andl worksl forl hours.l Nol usel inl orall asl firstl passl
effectl eliminatesl drugl immediately
·l Canl sendl ptl intol acutel withdrawal
·l Shortl half-lifel requiresl multiplel adminsl untill opioidl effectl isl gone
QUESTION
Naltrexonel Prescribing
Answer:
notl al controlledl substancel andl doesl notl requirel speciall trainingl orl certification.l
·l AKAl Vivitroll -l purel opioidl antagonistl usedl forl opioidl andl alcoholl abuse
ol Givenl afterl ptl undergoesl opioidl detoxl tol discouragel renewedl opioidl misuse
·l Preventsl euphorial inl opioidl abuse
·l Precipitatesl withdrawal,l usersl mustl bel renderedl opioidl freel priorl tol start
·l Doesl notl preventl opioidl cravingl causingl manyl addictsl tol faill treatment
ol Lessl successfull thanl methadonel whichl blocksl euphorial andl eliminatesl craving
·l Canl causel hepatocellularl injury,l notl forl patientsl withl acutel hepatitisl orl liverl injury
·l Givenl inl twol formulations
ol 50mgl tabletsl forl orall dosing
§l Dosingl schedule:l 100mgl Mondayl andl Wednesday,l 150mgl onl Fridayl orl 50mgl daily
ol ERl suspensionl (380mg/vail)l forl IMl dosingl oncel al month
QUESTION
Opioidl Overdosel Treatment
Answer:
·l Naloxonel isl administeredl forl emergencyl treatmentl ofl knownl orl suspectedl opioidl
overdose.
·l Advisel clientsl andl familyl membersl tol alwaysl calll 911l afterl outpatientl administration.l
Thisl isl becausel thel half-lifel ofl naloxonel isl shorterl thanl thel half-lifel ofl mostl opioids,l
andl whenl naloxonel wearsl off,l overdosel symptomsl willl return.
,QUESTION
opioid-inducedl constipation
Answer:
·l Opioidsl promotel constipationl throughl actionsl inl thel CNSl andl GIl tractl byl activatingl
Ul receptorl inl thel gut,l theyl canl suppressl propulsivel intestinall contractionsl (peristalsis),l
intensifyl nonpropulsivel contractions,l increasel tonel ofl anall sphincter,l inhibitl secretionl ofl
fluidl intol intestinall lumen.
·l Constipationl developsl inl fewl daysl ofl opioidl use
·l Canl causel fecall impaction,l bowell perforation,l rectall tearing,l hemorrhoids
·l GOAL:l producel stooll everyl 1l tol 2l days
ol Nondrugl methods:
§l Physicall activity,l increasedl intakel ofl fiberl andl fluids.l Enemas
ol Prophylacticl drugs:
§l Stimulantl laxativel (senna)l tol counterl reducedl bowell motility
§l Polyethylenel glycoll (osmoticl laxative)
ol Rescuel therapy
§l Ifl prophylactivel isl inadequate
§l Strongl osmoticl laxativel (lactulose,l sodiuml phosphate)
§l Lastl resortl methylnaltrexonel (Relistorl al purel opioidl antagonist),l orall drugl thatl blocksl
Ul receptorsl inl intestine
·l Doesl notl decreasel analgesia,l cannotl enterl CNS,l andl doesl notl precipitatel withdrawal
QUESTION
Tramadoll (Nonl opioidl centrallyl actingl analgesic)
Drugl Interactions
Answer:
·l Analogl ofl codeinel -l approvedl forl moderatel tol moderatelyl severel pain
·l Moderatelyl strong,l lowl riskl forl dependence,l abusel orl respiratoryl depression
ol Treatsl painl throughl opioidl andl nonopioidl mechanisms
§l Weakl agonistl activityl ofl Ul receptor
§l Blocksl NEl andl serotoninl uptake
·l Canl intensifyl CNSl depressantl responsel withl alcoholl andl benzos
·l Canl causel hypertensivel crisisl whenl combinedl withl monoaminel oxidasel inhibitorl
(MAOI)l duel tol inhibitingl NEl uptake
·l Canl causel serotoninl syndromel withl SSRIs.l SNRIs,l NEl reuptakel inhibitors,l tricyclicl
antidepressants,l MAOI'sl andl triptans.
, ·l Urinaryl retentionl andl constipationl whenl usedl withl anticholinergicl drugs
QUESTION
Opioidl Abusel Assessment
Answer:
·l opioidl usel canl leadl tol physicall dependencel inl onlyl 4-8l weeks.
·l Screenl forl riskl factorsl ofl opioidl misusel usingl al tooll likel thel NIDA-Modifiedl ASSIST
Inl thel pastl year,l howl oftenl havel youl usedl thel following:l alcohol,l tobacco,l prescriptionl
orl illegall drugs?
Inl yourl LIFETIME,l whichl ofl thel followingl substancesl havel youl everl used?l Cannabis,l
cocaine,l prescriptionl stimulants,l meth,l inhalants,l sedatives,l hallucinogenics,l streetl opioids,l
prescriptionl opioids,l other?
Inl thel pastl 3l months,l howl oftenl havel youl hadl al strongl desirel orl urgel tol usel (firstl
drug,l secondl drug,l etc)?
Duringl thel pastl 3l months,l howl oftenl hasl yourl usel ofl (firstl drug,l secondl drug,l etc)l ledl
tol health,l social,l legall orl financiall problems?
Duringl thel pastl 3l months,l howl oftenl havel youl failedl tol dol whatl wasl normallyl
expectedl ofl youl becausel ofl yourl usel ofl (firstl drug,l secondl drug,l etc)?
Hasl al friendl orl relativel orl anyonel elsel everl expressedl concernl aboutl yourl usel ofl (firstl
drug,l secondl drug,l etc)?
QUESTION
Opioidl Management
Answer:
·l Limitl numberl ofl opioidsl prescribedl atl onel time
·l Opioidsl arel notl firstl linel treatments
·l Usingl opioidsl onlyl afterl nonopioidl analgesicsl orl morel conservativel methodsl havel
failed
·l Discussingl benefitsl andl riskl ofl long-terml opioidsl withl thel patient
·l Whenl possible,l usingl onlyl onel prescriberl andl onel pharmacy
·l Ensuringl comprehensivel followl upl tol assessl efficacyl andl sidel effectsl ofl treatmentl andl
tol monitorl forl signsl ofl opioidl abuse
·l Stoppingl opioidsl afterl anl attemptl atl opioidl rotationl hasl producedl inadequatel benefit
·l Fullyl documentingl entirel process
