NR 565 ADVANCED PHARMACOLOGY MIDTERM /
CHAMBERLAIN NEWEST 2025 WITH COMPLETE
QUESTIONS AND CORRECT VERIFIED ANSWERS/
WELL GRADED A+
Assess someone for possible drug diversion? - CORRECT ANSWERS -Urine test at
least yearly
PDMP routinely
How does renal and hepatic function impact medication levels in body? - CORRECT
ANSWERS -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? - CORRECT ANSWERS -
Older adults metabolize opioids slowly and therefore require lower doses than younger
adults.
When should naloxone be prescribed? - CORRECT ANSWERS -with every opioid
prescription
What is the typical dose of naloxone and how is it administered? - CORRECT
ANSWERS -4 mg, nasal spray- one spray to one nostril
If no response, additional doses can be given every 2 to 3 minutes until emergency
services arrive
In regards to dosage, why do we need to be cautious when giving naloxone? -
CORRECT ANSWERS -Dosage must be titrated carefully bc if too much is given the
patient will swing from a state of intoxication to withdrawal
What is the half-life of naloxone? - CORRECT ANSWERS -Short- naloxone must be
administered every few hours until opioid concentrations have dropped to nontoxic
levels
US Drug Enforcement Administration description of the scheduled drugs - CORRECT
ANSWERS -The DEA enacted the Controlled Substances Act (CSA) in 1970 to regulate
drugs and other substances based on their potential for abuse and dependency. Five
schedules of controlled substances were created that are updated annually. Classes of
scheduled substances include narcotics, depressants, stimulants, hallucinogens, and
,anabolic steroids. The DEA issues eligible providers with a registration number to write
prescriptions for controlled substances.
Schedule I - CORRECT ANSWERS -high potential for abuse and no current accepted
medical use
example of schedule I - CORRECT ANSWERS -Heroin, Lysergic Acid Diethylamide
(LSD), Marijuana (cannabis), 3,4-Methylenedioxymethamphetamine (ecstasy),
Methaqualone, and Peyote
Schedule II - CORRECT ANSWERS -substances, or chemicals are defined as drugs
with a high potential for abuse, with use potentially leading to severe psychological or
physical dependence
Examples of schedule II - CORRECT ANSWERS -Combination products with less than
15 milligrams of Hydrocodone per dosage unit (Vicodin), Cocaine, Methamphetamine,
Methadone, Hydromorphone (Dilaudid), Meperidine (Demerol), Oxycodone
(OxyContin), Fentanyl, Dexedrine, Adderall, and Ritalin
Schedule III - CORRECT ANSWERS -substances, or chemicals are defined as drugs
with a moderate to low potential for physical and psychological dependence. Abuse
potential is less than schedule I and II drugs, but more than schedule IV
examples of schedule III - CORRECT ANSWERS -Products containing less than 90
milligrams of Codeine per dosage unit (Tylenol with codeine), Ketamine, Anabolic
steroids, Testosterone
Schedule IV - CORRECT ANSWERS -substances, or chemicals are defined as drugs
with a low potential for abuse and low risk of dependence
example schedule IV - CORRECT ANSWERS -Xanax, Soma, Darvon, Valium, Ativan,
Talwin, Ambien, Tramadol
Schedule V - CORRECT ANSWERS -substances or chemicals are defined as drugs
with lower potential for abuse than schedule IV and consist of preparations containing
limited quantities of certain narcotics. Are generally used for antidiarrheal, antitussive,
and analgesic purposes
example schedule V drugs - CORRECT ANSWERS -Cough preparations with less than
200 milligrams of Codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen,
Lyrica, Parepectolin
What type of analgesic for mild to moderate pain? - CORRECT ANSWERS -tylenol,
NSAID (Advil/motrin), COX2 inhibitors (like NSAIDS)
What type of analgesic for moderate to severe pain? - CORRECT ANSWERS -opioids
, When to start using short acting opioids? - CORRECT ANSWERS -Should be used
exclusively for acute pain in opioid naïve (never had before) patients as opposed to
opioid tolerant patients
Adverse effects of opioids - CORRECT ANSWERS -constipation
urinary retention
orthostatic hypotension
emesis
neurotoxicity (delirium, agitation)
tolerance and physical dependence
respiratory depression
What are strong opioids analgesics usually reserved for? - CORRECT ANSWERS -
moderate to severe pain, postoperative pain, labor and delivery, cancer, chronic pain,
hospice/palliative care, end of life, acute traumatic events, burns
Use of opioids and these other medications should be avoided and why? - CORRECT
ANSWERS -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? - CORRECT ANSWERS -
MAOI (hyperpyrexia coma)
coma, resp depression, pinpoint pupuls
How does strength of fentanyl compare to morphine - CORRECT ANSWERS -high
milligram potency (about 100 times that of morphine)
through what system is fentanyl metabolized? - CORRECT ANSWERS -CYP34A
(isoenzyme of CYP450), levels of fentanyl can be increased by CYP34A inhibitors
What is methadone used to treat? - CORRECT ANSWERS -relieve pain and treat
opioid addiction
For what level of pain is codeine prescribed? - CORRECT ANSWERS -mild to
moderate
CHAMBERLAIN NEWEST 2025 WITH COMPLETE
QUESTIONS AND CORRECT VERIFIED ANSWERS/
WELL GRADED A+
Assess someone for possible drug diversion? - CORRECT ANSWERS -Urine test at
least yearly
PDMP routinely
How does renal and hepatic function impact medication levels in body? - CORRECT
ANSWERS -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? - CORRECT ANSWERS -
Older adults metabolize opioids slowly and therefore require lower doses than younger
adults.
When should naloxone be prescribed? - CORRECT ANSWERS -with every opioid
prescription
What is the typical dose of naloxone and how is it administered? - CORRECT
ANSWERS -4 mg, nasal spray- one spray to one nostril
If no response, additional doses can be given every 2 to 3 minutes until emergency
services arrive
In regards to dosage, why do we need to be cautious when giving naloxone? -
CORRECT ANSWERS -Dosage must be titrated carefully bc if too much is given the
patient will swing from a state of intoxication to withdrawal
What is the half-life of naloxone? - CORRECT ANSWERS -Short- naloxone must be
administered every few hours until opioid concentrations have dropped to nontoxic
levels
US Drug Enforcement Administration description of the scheduled drugs - CORRECT
ANSWERS -The DEA enacted the Controlled Substances Act (CSA) in 1970 to regulate
drugs and other substances based on their potential for abuse and dependency. Five
schedules of controlled substances were created that are updated annually. Classes of
scheduled substances include narcotics, depressants, stimulants, hallucinogens, and
,anabolic steroids. The DEA issues eligible providers with a registration number to write
prescriptions for controlled substances.
Schedule I - CORRECT ANSWERS -high potential for abuse and no current accepted
medical use
example of schedule I - CORRECT ANSWERS -Heroin, Lysergic Acid Diethylamide
(LSD), Marijuana (cannabis), 3,4-Methylenedioxymethamphetamine (ecstasy),
Methaqualone, and Peyote
Schedule II - CORRECT ANSWERS -substances, or chemicals are defined as drugs
with a high potential for abuse, with use potentially leading to severe psychological or
physical dependence
Examples of schedule II - CORRECT ANSWERS -Combination products with less than
15 milligrams of Hydrocodone per dosage unit (Vicodin), Cocaine, Methamphetamine,
Methadone, Hydromorphone (Dilaudid), Meperidine (Demerol), Oxycodone
(OxyContin), Fentanyl, Dexedrine, Adderall, and Ritalin
Schedule III - CORRECT ANSWERS -substances, or chemicals are defined as drugs
with a moderate to low potential for physical and psychological dependence. Abuse
potential is less than schedule I and II drugs, but more than schedule IV
examples of schedule III - CORRECT ANSWERS -Products containing less than 90
milligrams of Codeine per dosage unit (Tylenol with codeine), Ketamine, Anabolic
steroids, Testosterone
Schedule IV - CORRECT ANSWERS -substances, or chemicals are defined as drugs
with a low potential for abuse and low risk of dependence
example schedule IV - CORRECT ANSWERS -Xanax, Soma, Darvon, Valium, Ativan,
Talwin, Ambien, Tramadol
Schedule V - CORRECT ANSWERS -substances or chemicals are defined as drugs
with lower potential for abuse than schedule IV and consist of preparations containing
limited quantities of certain narcotics. Are generally used for antidiarrheal, antitussive,
and analgesic purposes
example schedule V drugs - CORRECT ANSWERS -Cough preparations with less than
200 milligrams of Codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen,
Lyrica, Parepectolin
What type of analgesic for mild to moderate pain? - CORRECT ANSWERS -tylenol,
NSAID (Advil/motrin), COX2 inhibitors (like NSAIDS)
What type of analgesic for moderate to severe pain? - CORRECT ANSWERS -opioids
, When to start using short acting opioids? - CORRECT ANSWERS -Should be used
exclusively for acute pain in opioid naïve (never had before) patients as opposed to
opioid tolerant patients
Adverse effects of opioids - CORRECT ANSWERS -constipation
urinary retention
orthostatic hypotension
emesis
neurotoxicity (delirium, agitation)
tolerance and physical dependence
respiratory depression
What are strong opioids analgesics usually reserved for? - CORRECT ANSWERS -
moderate to severe pain, postoperative pain, labor and delivery, cancer, chronic pain,
hospice/palliative care, end of life, acute traumatic events, burns
Use of opioids and these other medications should be avoided and why? - CORRECT
ANSWERS -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? - CORRECT ANSWERS -
MAOI (hyperpyrexia coma)
coma, resp depression, pinpoint pupuls
How does strength of fentanyl compare to morphine - CORRECT ANSWERS -high
milligram potency (about 100 times that of morphine)
through what system is fentanyl metabolized? - CORRECT ANSWERS -CYP34A
(isoenzyme of CYP450), levels of fentanyl can be increased by CYP34A inhibitors
What is methadone used to treat? - CORRECT ANSWERS -relieve pain and treat
opioid addiction
For what level of pain is codeine prescribed? - CORRECT ANSWERS -mild to
moderate
