Week 2 NR 565
Guiding principles for prescribers - correct answer ✔ ✔ 1. Be clear about the
reasons for prescribing
2. Take into account the patient's medication history before prescribing
3. Take into account other factors that might alter the benefits and risks of
treatment
4. Take into account the patient's ideas, concerns, and expectations
5. Select effective, safe, and cost effective medicines individualised for the patient
6. Adhere to national guidelines and local formularies where appropriate
7. Write unambiguous legal prescriptions using the correct documentation
8. Monitor the beneficial and adverse effects of medicines
9. Communicate and document prescribing decisions and the reasons for them
10. Prescribe within the limitations of your knowledge, skills and experience
Examples of pure opioid agonists - correct answer ✔ ✔ Examples of full
agonists are heroin, oxycodone, methadone, hydrocodone, morphine, opium and
others.
What is used to calculate a patient's overdose risk? - correct answer ✔ ✔
Dosages at or above 50 MME/day increase risks for overdose by at least
Calculating the total daily dose of opioids helps identify patients who may benefit
from closer monitoring, reduction or tapering of opioids, prescribing of naloxone,
or other measures to reduce risk of overdose.
, 50 MME/day:
50 mg of hydrocodone (10 tablets of hydrocodone/ acetaminophen 5/300)
33 mg of oxycodone (~2 tablets of oxycodone sustained-release 15 mg)
12 mg of methadone ( <3 tablets of methadone 5 mg)
90 MME/day:
• 90 mg of hydrocodone (9 tablets of hydrocodone/ acetaminophen 10/325)
• 60 mg of oxycodone (~2 tablets of oxycodone sustained-release 30 mg)
• ~20 mg of methadone (4 tablets of methadone 5 mg)
How would you know when to refer someone to a pain specialist for pain
management? - correct answer ✔ ✔ If the cause of the pain is known (or
unknown), serious disease excluded, no curative treatment is readily available,
current treatment is not helping, or the pain interferes with daily function, referral
should to a pain specialist should be considered.
Prescription Drug Monitoring Program (PDMP)
o What is it?
o Why is it important? - correct answer ✔ ✔ A prescription drug monitoring
program (PDMP) is an electronic database that tracks controlled substance
prescriptions. PDMPs can help identify patients who may be misusing prescription
opioids or other prescription drugs and who may be at risk for overdose.
It's an important step to improve opioid prescribing practices.
Guiding principles for prescribers - correct answer ✔ ✔ 1. Be clear about the
reasons for prescribing
2. Take into account the patient's medication history before prescribing
3. Take into account other factors that might alter the benefits and risks of
treatment
4. Take into account the patient's ideas, concerns, and expectations
5. Select effective, safe, and cost effective medicines individualised for the patient
6. Adhere to national guidelines and local formularies where appropriate
7. Write unambiguous legal prescriptions using the correct documentation
8. Monitor the beneficial and adverse effects of medicines
9. Communicate and document prescribing decisions and the reasons for them
10. Prescribe within the limitations of your knowledge, skills and experience
Examples of pure opioid agonists - correct answer ✔ ✔ Examples of full
agonists are heroin, oxycodone, methadone, hydrocodone, morphine, opium and
others.
What is used to calculate a patient's overdose risk? - correct answer ✔ ✔
Dosages at or above 50 MME/day increase risks for overdose by at least
Calculating the total daily dose of opioids helps identify patients who may benefit
from closer monitoring, reduction or tapering of opioids, prescribing of naloxone,
or other measures to reduce risk of overdose.
, 50 MME/day:
50 mg of hydrocodone (10 tablets of hydrocodone/ acetaminophen 5/300)
33 mg of oxycodone (~2 tablets of oxycodone sustained-release 15 mg)
12 mg of methadone ( <3 tablets of methadone 5 mg)
90 MME/day:
• 90 mg of hydrocodone (9 tablets of hydrocodone/ acetaminophen 10/325)
• 60 mg of oxycodone (~2 tablets of oxycodone sustained-release 30 mg)
• ~20 mg of methadone (4 tablets of methadone 5 mg)
How would you know when to refer someone to a pain specialist for pain
management? - correct answer ✔ ✔ If the cause of the pain is known (or
unknown), serious disease excluded, no curative treatment is readily available,
current treatment is not helping, or the pain interferes with daily function, referral
should to a pain specialist should be considered.
Prescription Drug Monitoring Program (PDMP)
o What is it?
o Why is it important? - correct answer ✔ ✔ A prescription drug monitoring
program (PDMP) is an electronic database that tracks controlled substance
prescriptions. PDMPs can help identify patients who may be misusing prescription
opioids or other prescription drugs and who may be at risk for overdose.
It's an important step to improve opioid prescribing practices.
