NR567 ADVANCED PHARMACOLOGY FOR THE
AGACNP WEEK 5 2026 EXAM PREP STUDY
GUIDE COMPREHENSIVE REVIEW
◉ Major Depressive Episode
-Psychomotor. Answer: Match diagnostic symptom to
Malfunctioning Brain Circuit: Cerebellum (C)
◉ -Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation. Answer: adverse effects associated with the acute use of
opioids:
◉ -Prototype opioid agonist
-indicated for acute pain
-binds to opioid receptors in the CNS, inhibiting ascending pain
pathways, altering the perception & response to pain
-also produces CNS depression and potentially respiratory
depression
,*may be life-threatening, especially if utilized with benzodiazepines,
CNS depressants, or alcohol
onset of action:
-immediate release formulation is patient-dependent, with variable
absorption.
-IV is 5-10 minutes, with a duration 3-5 hours.
-Also available in controlled release formulation (MS Contin) and
extended-release morphine (Avinza).. Answer: Opioid medication:
Morphine
◉ -has an almost immediate onset of action when given IV, with a
duration of 0.5-1 hour
-More potent than morphine, but short duration of action
-the preferred opioid for those unable to tolerate morphine or
hydromorphone and in those with severe hepatic and renal disease
-same indications as morphine and is also used frequently in
procedural sedation and general anesthesia
-Conversion between fentanyl products is NOT mcg for mcg. Answer:
Opioid medication: Fentanyl
◉ -Similar opioid agonist as morphine but more potent
,-Oral and parenteral doses are not equivalent (parenteral doses up
to 5 times more potent). Answer: Opioid medication:
Hydromorphone
◉ -No longer recommended as an analgesic, and not widely
available.
-Has numerous concerning adverse effects such as seizures and
delirium.. Answer: Opioid medication: Meperidine
◉ -Utilized in detoxification and maintenance treatment of opioid
addiction and heroin addiction, with high variability among patients
-long acting opioid that binds to and occupies mu-opioid receptors,
reducing craving for opioids and prevents withdrawal symptoms for
24 hours
-potential for abuse, only licensed opioid treatment programs or
licensed inpatient hospital units permitted to order and dispense
this medication
-potential for life threatening respiratory depression and QT
prolongation
-Equianalgesic conversion ratios between methadone and other
opioids are individually variable, with deaths occurring during
conversion from chronic high dose opiate history or opioid abuse to
methadone
-Discontinuation requires a wean to avoid withdrawal
, -pregnant, a risk benefit ratio is necessary as fetal outcomes are
improved as compared to illicit drug use, however can have
decreased birth weight, length, head circumference. Answer: Opioid
medication: Methadone (Dolophine, Methadose)
◉ -Medication useful in general anesthesia and procedural sedation
-off label usage as infusions for acute pain, as both a stand-alone
treatment, as an adjunctive option with opioids, as well as an
intranasal formulation.. Answer: Opioid medication: Ketamine
◉ -Opioid agonist, with similar indications and side effect profile as
other opioids, but that also blocks reuptake of serotonin and
norepinephrine.
-Indicated for acute pain management, with added benefit for
patients with neuropathic pain and nociceptive pain.
-Has a lower risk of constipation and dependence than other
opioids, but does have risk of serotonin syndrome.. Answer: Opioid
medication: Tramadol
◉ -pure antagonist, with clinical indication for treatment of acute
opioid overdose.
-IV naloxone can dramatically reverse opioids, even in comatose
states
AGACNP WEEK 5 2026 EXAM PREP STUDY
GUIDE COMPREHENSIVE REVIEW
◉ Major Depressive Episode
-Psychomotor. Answer: Match diagnostic symptom to
Malfunctioning Brain Circuit: Cerebellum (C)
◉ -Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation. Answer: adverse effects associated with the acute use of
opioids:
◉ -Prototype opioid agonist
-indicated for acute pain
-binds to opioid receptors in the CNS, inhibiting ascending pain
pathways, altering the perception & response to pain
-also produces CNS depression and potentially respiratory
depression
,*may be life-threatening, especially if utilized with benzodiazepines,
CNS depressants, or alcohol
onset of action:
-immediate release formulation is patient-dependent, with variable
absorption.
-IV is 5-10 minutes, with a duration 3-5 hours.
-Also available in controlled release formulation (MS Contin) and
extended-release morphine (Avinza).. Answer: Opioid medication:
Morphine
◉ -has an almost immediate onset of action when given IV, with a
duration of 0.5-1 hour
-More potent than morphine, but short duration of action
-the preferred opioid for those unable to tolerate morphine or
hydromorphone and in those with severe hepatic and renal disease
-same indications as morphine and is also used frequently in
procedural sedation and general anesthesia
-Conversion between fentanyl products is NOT mcg for mcg. Answer:
Opioid medication: Fentanyl
◉ -Similar opioid agonist as morphine but more potent
,-Oral and parenteral doses are not equivalent (parenteral doses up
to 5 times more potent). Answer: Opioid medication:
Hydromorphone
◉ -No longer recommended as an analgesic, and not widely
available.
-Has numerous concerning adverse effects such as seizures and
delirium.. Answer: Opioid medication: Meperidine
◉ -Utilized in detoxification and maintenance treatment of opioid
addiction and heroin addiction, with high variability among patients
-long acting opioid that binds to and occupies mu-opioid receptors,
reducing craving for opioids and prevents withdrawal symptoms for
24 hours
-potential for abuse, only licensed opioid treatment programs or
licensed inpatient hospital units permitted to order and dispense
this medication
-potential for life threatening respiratory depression and QT
prolongation
-Equianalgesic conversion ratios between methadone and other
opioids are individually variable, with deaths occurring during
conversion from chronic high dose opiate history or opioid abuse to
methadone
-Discontinuation requires a wean to avoid withdrawal
, -pregnant, a risk benefit ratio is necessary as fetal outcomes are
improved as compared to illicit drug use, however can have
decreased birth weight, length, head circumference. Answer: Opioid
medication: Methadone (Dolophine, Methadose)
◉ -Medication useful in general anesthesia and procedural sedation
-off label usage as infusions for acute pain, as both a stand-alone
treatment, as an adjunctive option with opioids, as well as an
intranasal formulation.. Answer: Opioid medication: Ketamine
◉ -Opioid agonist, with similar indications and side effect profile as
other opioids, but that also blocks reuptake of serotonin and
norepinephrine.
-Indicated for acute pain management, with added benefit for
patients with neuropathic pain and nociceptive pain.
-Has a lower risk of constipation and dependence than other
opioids, but does have risk of serotonin syndrome.. Answer: Opioid
medication: Tramadol
◉ -pure antagonist, with clinical indication for treatment of acute
opioid overdose.
-IV naloxone can dramatically reverse opioids, even in comatose
states
