NSG533 / NSG 533 EXAM 2
Advanced Pharmacology - Wilkes
Actual Questions and Answers
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Grade A+ Wilkes
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Each Question Includes The Correct Answer
Expert-Verified explanation
1/8
,1. What would you be concerned with regarding the first patient's use of Vicodin in terms of the dose
acetaminophen?
Answer:
In elderly patients, it is recommended not to exceed 3,000 mg per day of acetaminophen.
Rationale:
Older adults have increased risk of hepatotoxicity from acetaminophen, especially with chronic use or liver
impairment. Since Vicodin contains both hydrocodone and acetaminophen, the total daily dose from all sources
should be monitored closely to avoid accidental overdose.
---
2. What medication could you recommend for a diabetic patient in pain that could also be used to help treat
depression?
Answer:
SNRIs such as duloxetine or venlafaxine have been successfully used in diabetic peripheral neuropathy.
Rationale:
Both duloxetine and venlafaxine can help not only with the neuropathic pain of diabetes but also with comorbid
depression, thus addressing two aspects of the patient's health with a single agent.
---
3. In addition, be sure to understand which non-opioid medications you would use for a patient with neuropathic
pain:
Answer:
Gabapentin, pregabalin, transdermal lidocaine, and TCAs.
Rationale:
These are first-line, evidence-based non-opioid medications that can effectively treat neuropathic pain syndromes,
2/8
, each with specific indications and monitoring parameters.
---
4. If a patient has a true allergy to morphine, what opioid, if any, could you try instead?
Answer:
When a true allergy is present, use an agent from another opioid class, such as fentanyl.
Rationale:
Fentanyl is a synthetic opioid with a different structure from morphine and is less likely to cause cross-reactivity in
true opioid allergies.
---
5. Know the common side effects which opioids can cause:
Answer:
Excessive sedation (reduce dose by 25%), constipation, nausea/vomiting (treat with hydroxyzine or
diphenhydramine), gastroparesis, vertigo, respiratory depression, CNS irritability.
Rationale:
Opioids have widespread effects on the CNS and GI tract, necessitating close monitoring and preemptive
management of side effects, especially constipation and sedation.
---
6. Know the WHO pain treatment algorithm:
Answer:
1. Mild pain (1-3): non-opioid scheduled ATC
2. Moderate pain (4-6): add opioid to scheduled non-opioid ATC
3/8
Advanced Pharmacology - Wilkes
Actual Questions and Answers
100% Guarantee Pass
This Exam contains:
Grade A+ Wilkes
100% Guarantee Pass.
Each Question Includes The Correct Answer
Expert-Verified explanation
1/8
,1. What would you be concerned with regarding the first patient's use of Vicodin in terms of the dose
acetaminophen?
Answer:
In elderly patients, it is recommended not to exceed 3,000 mg per day of acetaminophen.
Rationale:
Older adults have increased risk of hepatotoxicity from acetaminophen, especially with chronic use or liver
impairment. Since Vicodin contains both hydrocodone and acetaminophen, the total daily dose from all sources
should be monitored closely to avoid accidental overdose.
---
2. What medication could you recommend for a diabetic patient in pain that could also be used to help treat
depression?
Answer:
SNRIs such as duloxetine or venlafaxine have been successfully used in diabetic peripheral neuropathy.
Rationale:
Both duloxetine and venlafaxine can help not only with the neuropathic pain of diabetes but also with comorbid
depression, thus addressing two aspects of the patient's health with a single agent.
---
3. In addition, be sure to understand which non-opioid medications you would use for a patient with neuropathic
pain:
Answer:
Gabapentin, pregabalin, transdermal lidocaine, and TCAs.
Rationale:
These are first-line, evidence-based non-opioid medications that can effectively treat neuropathic pain syndromes,
2/8
, each with specific indications and monitoring parameters.
---
4. If a patient has a true allergy to morphine, what opioid, if any, could you try instead?
Answer:
When a true allergy is present, use an agent from another opioid class, such as fentanyl.
Rationale:
Fentanyl is a synthetic opioid with a different structure from morphine and is less likely to cause cross-reactivity in
true opioid allergies.
---
5. Know the common side effects which opioids can cause:
Answer:
Excessive sedation (reduce dose by 25%), constipation, nausea/vomiting (treat with hydroxyzine or
diphenhydramine), gastroparesis, vertigo, respiratory depression, CNS irritability.
Rationale:
Opioids have widespread effects on the CNS and GI tract, necessitating close monitoring and preemptive
management of side effects, especially constipation and sedation.
---
6. Know the WHO pain treatment algorithm:
Answer:
1. Mild pain (1-3): non-opioid scheduled ATC
2. Moderate pain (4-6): add opioid to scheduled non-opioid ATC
3/8
