ACTUAL QUESTIONS AND EXPERT
VERIFIED ANSWERS 100% SCORE GRADED
A+
⩥What type of analgesic for mild to moderate pain? Answer: tylenol,
NSAID (Advil/motrin), COX2 inhibitors (like NSAIDS)
⩥What type of analgesic for moderate to severe pain? Answer: opioids
⩥When to start using short acting opioids? Answer: Should be used
exclusively for acute pain in opioid naïve (never had before) patients as
opposed to opioid tolerant patients
⩥Adverse effects of opioids Answer: constipation
urinary retention
orthostatic hypotension
emesis
neurotoxicity (delirium, agitation)
tolerance and physical dependence
respiratory depression
,⩥What are strong opioids analgesics usually reserved for? Answer:
moderate to severe pain, postoperative pain, labor and delivery, cancer,
chronic pain, hospice/palliative care, end of life, acute traumatic events,
burns
⩥Use of opioids and these other medications should be avoided and
why? Answer: respiratory depression with other drugs with CNS
depressant action
CNS depressants
barbiturates
benzo
alcohol
general aesthetics
anti-histamines
phenothiazine
anticholinergic drugs
atropine
tricyclic antidepressants (constipation and urinary retention)
⩥what is the classic triad of symptoms for an opioid overdose? Answer:
MAOI (hyperpyrexia coma)
coma, resp depression, pinpoint pupuls
, ⩥How does strength of fentanyl compare to morphine Answer: high
milligram potency (about 100 times that of morphine)
⩥through what system is fentanyl metabolized? Answer: CYP34A
(isoenzyme of CYP450), levels of fentanyl can be increased by CYP34A
inhibitors
⩥What is methadone used to treat? Answer: relieve pain and treat opioid
addiction
⩥For what level of pain is codeine prescribed? Answer: mild to
moderate
⩥What does 10% of codeine convert to/black box warning Answer: 10%
of each dose of codeine undergoes conversion to morphine, the active
form of codeine (led to death in children and toxicity in infants through
breast milk)
⩥Black box warning for hydrocodone Answer: products that contain
Tylenol are associated with hepatotoxicity
⩥Black box warning opioids, fentanyl, oxycodone, hydromorphone,
oxymorphone Answer: respiratory depression