NR 565 Midterm EXAM
12 CDC guidelines when prescribing opioids - ANSWER 1. Opioids are NOT 1st line
2. est. goals for pain & Fxn
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3. discuss risks and benefits
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4. Use IR to start
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5. lowest effective dose
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6. prescribe short durations for acute pain
7. eval. benefits and harm frequently
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8. Use strats to mitigate risk
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9. Review PDMP data
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10. us UA testing
11. avoid concurrent opioid and Benzo prescribing
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12. offer tx for OUD
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A 41 year old patient comes into the clinic complaining of increased heart rate after
starting Nitro patches for stable angina. What would an appropriate response be?
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A. Lets lower the dose and frequency of use
B. I will prescribe a beta blocker to help with this
C. Next time this happens, lie down and practice deep breathing, this will bring your
heart rate down. - ANSWER B. I will prescribe a beta blocker to help with this
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A 55 year old male comes into the clinic with a gouty arthritis. He states that he has one
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flareup a year. Your response is:
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A. I will prescribe you glucocorticoids to help with inflammation
B. Lets start you on a prophylactic therapy of colchicine.
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C. It will be helpful to take an NSAID to start with to help relieve some inflammation.
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Ill prescribe Naproxen. - ANSWER C. It will be helpful to take an NSAID to start with
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to help relieve some inflammation. Ill prescribe Naproxen.
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A patient comes in stating that he tried NSAIDS to relieve a gouty attack but it just
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hasn't helped. He asks, "what are my options?" He further states that he has attacks every
few years but when he does NSADIS "never help." Your response is:
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A. I can prescribe a glucocorticoid (Prednisone) and that will bring down the
inflammation/pain.
B. Have you tried increasing your dosage of NSAIDS and drink plenty of water?
C. Lets start by making some changes in your diet, can you tell me what you eat
regularly? - ANSWER A. I can prescribe a glucocorticoid (Prednisone) and that will
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bring down the inflammation/pain.
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A patient with HF develops fibrotic changes, what should the provider do next? -
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ANSWER Prescribe an ARB- inhibits fibrosis
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Adverse Effects of Colchicine? - ANSWER GI
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myelosuppression or injury to proliferating cells (leukopenia, granulocytopenia,
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thrombocytopenia, and pancytopenia
Myopathy or Rhabdo (long term tx)
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CAUTION: Statins
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Allopurinol can cause what condition when taken long-term? - ANSWER
Hypersensitivity syndrome- rash
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