NR565 Week 2 Study Guide
Principles to guide prescribers determining when to initiate or continue opioids for chronic pain
selection, dosage, duration, follow-up, and withdrawal from opioids determining the risk and
addressing the negative effects of opioid use Opioids are not first-line therapy
Establish goals for pain and function
Discuss the benefits and risks. Opioids with an immediate release should be used to Use the
lowest possible dosage. Prescribe short durations for acute pain
Regularly weigh the benefits and drawbacks. Use strategies to mitigate risk
Review PDMP data
Use urine drug testing
Avoid prescribing benzodiazepines and opioids simultaneously. Offer treatment for opioid
disorder
·Examples of pure opioid agonists
pure opioid antagonists act as antagonists at µ and κ receptors.Narcan (Naloxone)
What is used to calculate a patient's overdose risk?
Scale of morphine equivalent in milligrams How would you know when to refer a patient for pain
management to a pain specialist? When patients take 120 mg per day of morphine milligram
equivalents
Prescription Drug Monitoring Program (PDMP), what is it?
online state based databases that contain info about controlled substance prescriptions
Why is it important? improve safety, inform clinical practice, and promote safer opioid
prescribing How to assess someone for possible drug diversion
Strange stories, reluctance to cooperate high or low understanding of meds, specific drug
requests, strange symptoms,
·How renal and hepatic function impact medication levels in the body
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.
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.
When should naloxone be prescribed for a patient?
When considering increasing dosage to >=50 MME/day
to get out of a coma or severe respiratory depression in absence of opioids naloxone has no
significant effects, if administered before opioid, naloxone will block opioid action
"Behaviors that suggest an addiction to controlled substances" Age at first use, impulse control,
trauma exposure, environment, family history, mental health, depression, and anxiety (ADHD),
new stage of life Schedule II drugs
chemicals or drugs that have a high risk of abuse and could cause severe mental or physical
dependence. Guidelines for prescribing Schedule II medications Rules around prescribing
Principles to guide prescribers determining when to initiate or continue opioids for chronic pain
selection, dosage, duration, follow-up, and withdrawal from opioids determining the risk and
addressing the negative effects of opioid use Opioids are not first-line therapy
Establish goals for pain and function
Discuss the benefits and risks. Opioids with an immediate release should be used to Use the
lowest possible dosage. Prescribe short durations for acute pain
Regularly weigh the benefits and drawbacks. Use strategies to mitigate risk
Review PDMP data
Use urine drug testing
Avoid prescribing benzodiazepines and opioids simultaneously. Offer treatment for opioid
disorder
·Examples of pure opioid agonists
pure opioid antagonists act as antagonists at µ and κ receptors.Narcan (Naloxone)
What is used to calculate a patient's overdose risk?
Scale of morphine equivalent in milligrams How would you know when to refer a patient for pain
management to a pain specialist? When patients take 120 mg per day of morphine milligram
equivalents
Prescription Drug Monitoring Program (PDMP), what is it?
online state based databases that contain info about controlled substance prescriptions
Why is it important? improve safety, inform clinical practice, and promote safer opioid
prescribing How to assess someone for possible drug diversion
Strange stories, reluctance to cooperate high or low understanding of meds, specific drug
requests, strange symptoms,
·How renal and hepatic function impact medication levels in the body
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.
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.
When should naloxone be prescribed for a patient?
When considering increasing dosage to >=50 MME/day
to get out of a coma or severe respiratory depression in absence of opioids naloxone has no
significant effects, if administered before opioid, naloxone will block opioid action
"Behaviors that suggest an addiction to controlled substances" Age at first use, impulse control,
trauma exposure, environment, family history, mental health, depression, and anxiety (ADHD),
new stage of life Schedule II drugs
chemicals or drugs that have a high risk of abuse and could cause severe mental or physical
dependence. Guidelines for prescribing Schedule II medications Rules around prescribing
