NR565 Week 2 Study Guide
·Guiding principles for prescribers - answer determining when to initiate or continue
opioids for chronic pain
opioid selection, dosage, duration, follow-up, and discontinuation
assessing risk and addressing harms of opioid use
Opioids are not first-line therapy
Establish goals for pain and function
Discuss risk and benefits
Use immediate-release opioids when starting
Use the lowest effective dose
Prescribe short durations for acute pain
Evaluate benefits and harms frequently
Use strategies to mitigate risk
Review PDMP data
Use urine drug testing
Avoid concurrent opioid and benzodiazepine prescribing
Offer treatment for opioid disorder
·Examples of pure opioid agonists - answerpure opioid antagonists act as antagonists at
µ and κ receptors.Narcan (Naloxone)
What is used to calculate a patient's overdose risk? - answerMorphine milligram
equivalent scale
How would you know when to refer someone to a pain specialist for pain management?
- answerWhen patients take 120 mg per day of morphine milligram equivalents
Prescription Drug Monitoring Program (PDMP), what is it? - answeronline state based
databases that contain info about controlled substance prescriptions
Why is it important? promote safer opioid prescribing, inform clinical practice and
improve safety
How to assess someone for possible drug diversion - answerStrange 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 - answerRenal 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? - answerWhen considering
increasing dosage to >=50 MME/day
to reverse pronounced respiratory depression, coma
·Guiding principles for prescribers - answer determining when to initiate or continue
opioids for chronic pain
opioid selection, dosage, duration, follow-up, and discontinuation
assessing risk and addressing harms of opioid use
Opioids are not first-line therapy
Establish goals for pain and function
Discuss risk and benefits
Use immediate-release opioids when starting
Use the lowest effective dose
Prescribe short durations for acute pain
Evaluate benefits and harms frequently
Use strategies to mitigate risk
Review PDMP data
Use urine drug testing
Avoid concurrent opioid and benzodiazepine prescribing
Offer treatment for opioid disorder
·Examples of pure opioid agonists - answerpure opioid antagonists act as antagonists at
µ and κ receptors.Narcan (Naloxone)
What is used to calculate a patient's overdose risk? - answerMorphine milligram
equivalent scale
How would you know when to refer someone to a pain specialist for pain management?
- answerWhen patients take 120 mg per day of morphine milligram equivalents
Prescription Drug Monitoring Program (PDMP), what is it? - answeronline state based
databases that contain info about controlled substance prescriptions
Why is it important? promote safer opioid prescribing, inform clinical practice and
improve safety
How to assess someone for possible drug diversion - answerStrange 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 - answerRenal 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? - answerWhen considering
increasing dosage to >=50 MME/day
to reverse pronounced respiratory depression, coma
