Week 6: NR546 / NR 546 (Latest Update 2025 / 2026) Advanced Pharmacology Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner | Questions with Verified Answers – Chamberlain.

Week 6: NR546 / NR 546 (Latest Update )
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Advanced Pharmacology Psychopharmacology for the
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Psychiatric-Mental Health Nurse Practitioner | i,- i,- i,- i,- i,-




Questions with Verified Answers – Chamberlain. i,- i,- i,- i,- i,-




Addiction is often driven by the client's attempts to:
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medicate an underlying mental health disorder
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adverse effects associated with the acute use of opioids:
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Itching
-Constipation
-Respiratory depression i,-




-Urinary retention i,-




-Sedation


Opioid medication: Morphine
i,- i,- i,-i,- i,- -Prototype opioid agonist i,- i,-




-indicated for acute pain i,- i,- i,-




-binds to opioid receptors in the CNS, inhibiting ascending pain
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pathways, altering the perception & response to pain
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-also produces CNS depression and potentially respiratory
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depression

,*may be life-threatening, especially if utilized with
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benzodiazepines, CNS depressants, or alcohol i,- i,- i,- i,-




onset of action: i,- i,-




-immediate release formulation is patient-dependent, with i,- i,- i,- i,- i,- i,-



variable absorption. i,- i,-




-IV is 5-10 minutes, with a duration 3-5 hours.
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-Also available in controlled release formulation (MS Contin) and
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extended-release morphine (Avinza). i,- i,-




Opioid medication: Fentanyl -has an almost immediate onset
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of action when given IV, with a duration of 0.5-1 hour
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-More potent than morphine, but short duration of action
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-the preferred opioid for those unable to tolerate morphine or
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hydromorphone and in those with severe hepatic and renal i,- i,- i,- i,- i,- i,- i,- i,- i,-



disease
-same indications as morphine and is also used frequently in
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procedural sedation and general anesthesia i,- i,- i,- i,-




-Conversion between fentanyl products is NOT mcg for mcg i,- i,- i,- i,- i,- i,- i,- i,-




Opioid medication: Hydromorphone i,- i,- i,-i,- i,- -Similar opioid agonist i,- i,- i,-



as morphine but more potent
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,-Oral and parenteral doses are not equivalent (parenteral doses
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up to 5 times more potent)
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Opioid medication: Meperidine i,- -No longer recommended as i,- i,-i,- i,- i,- i,- i,- i,-



an analgesic, and not widely available.
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-Has numerous concerning adverse effects such as seizures and
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delirium.


Opioid medication: Methadone i,- -Utilized in detoxification and i,- i,-i,- i,- i,- i,- i,- i,-



maintenance treatment of opioid addiction and heroin addiction, i,- i,- i,- i,- i,- i,- i,- i,-



with high variability among patients
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-long acting opioid that binds to and occupies mu-opioid
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receptors, reducing craving for opioids and prevents withdrawal
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symptoms for 24 hours i,- i,- i,-




-potential for abuse, only licensed opioid treatment programs or
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licensed inpatient hospital units permitted to order and dispense
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this medication
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-potential for life threatening respiratory depression and QT
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prolongation
-Equianalgesic conversion ratios between methadone and other i,- i,- i,- i,- i,- i,- i,-



opioids are individually variable, with deaths occurring during
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conversion from chronic high dose opiate history or opioid abuse
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to methadone
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-Discontinuation requires a wean to avoid withdrawal i,- i,- i,- i,- i,- i,-

, -pregnant, a risk benefit ratio is necessary as fetal outcomes are
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improved as compared to illicit drug use, however can have
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decreased birth weight, length, head circumference and fetal
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growth


Opioid medication: Ketamine
i,- -Medication useful in general i,- i,-i,- i,- i,- i,- i,- i,-



anesthesia and procedural sedation i,- i,- i,-




-off label usage as infusions for acute pain, as both a stand-alone
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treatment, as an adjunctive option with opioids, as well as an
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intranasal formulation. i,-




Opioid medication: Tramadol
i,- -Opioid agonist, with similar i,- i,-i,- i,- i,- i,- i,- i,-



indications and side effect profile as other opioids, but that also
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blocks reuptake of serotonin and norepinephrine.
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-Indicated for acute pain management, with added benefit for
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patients with neuropathic pain and nociceptive pain.
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-Has a lower risk of constipation and dependence than other
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opioids, but does have risk of serotonin syndrome.
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Opioid medication: Naloxone
i,- -pure antagonist, with clinical i,- i,-i,- i,- i,- i,- i,- i,-



indication for treatment of acute opioid overdose.
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-IV naloxone can dramatically reverse opioids, even in comatose
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states