NUR 524 EXAM 2 215 QUESTIONS AND
ANSWERS 2024 UPDATE
1. Analgesics: drugs that relieve pain without intentionally causing the
loss of consciousness
2. Opioid: a general term that is defined as any drug, natural or
synthetic, that has actions similar to those of morphine
-morphine is the original; everything funnels back to morphine
3. Opiate: a term that applies only to compounds present in opium 4.
Morphine and codeine: pure opioid agonists opioids that perpetuate a
response when it activates within a receptor to produce analgesia,
euphoria, sedations, respiratory depression, physical dependence,
constipation, etc.
Ex. Codeine converts to morphine when metabolized
5. About 5 days: how long does it take for physical dependence to
develop in a patient taking pure opioid agonists?
6. Pentazocine (Talwin)/buprenorphine (Butrans): agonist-antagonist
opioid class
Opioid medication class with the potential to both relieve pain and block
pain relief with opioid misuse
,-may be a good choice for opioid agonist discontinuation
7. If administered with a pure opioid agonist (ex. Oxycodone), it can
antagonize analgesia caused by the pure agonist
-given alone, will produce analgesia: what happens if you administer
pentazocine (Talwin) or buprenorphine (Butrans) with Oxycodone? 8.
Naloxone (Narcan): pure opioid antagonist medication that does not
produce analgesia or any of the other effects of opioids agonists
-reverses respiratory and CNS depression caused by overdose of opioid
agonist
9. Pain relief, anxiety reduction, sense of well-being
-side effects include drowsiness and mental cloudiness: what are the
three basic actions of morphine?
10. Morphine pharmacological actions: -respiratory depression -
constipation
-urinary retention
-orthostatic hypotension
-emesis
-miosis
-cough suppression
-biliary colic
,Tolerance and physical dependence within 5 days
11. Miosis: constricted pupils
12. Relieves pain without affecting the other senses by mimicking the
actions of endogenous opioid peptides primarily at mu receptors:
how does morphine therapeutically relieve pain?
13. Medications shouldn't be used for a time that would exceed the
time of the presenting pain
-if pain progresses, we need to look further into whether they're being
honest about their pain or what else could be causing the pain ex. If a
patient comes in with a broken leg, pain should last for approx. 3 days;
give the patient 3 days of opioids and then bridge to Ibuprofen: how
should NP's prescribe opioids to non-cancerous patients with no clear
guidelines?
14. Medication naive patients will only receive an opioid prescription
for 72 hours
-after they will need to come back in for re-evaluation for pain
management: what is the 72-hour window rule for opioid presciptions?
15. Do not combine opioid medication with other CNS depressant
actions -overview what medications the patient is already taking
, and educate them to not take both medications in the same
timeframe/window: what should we educate our patients on
regarding morphine and other CNS depressant medications?
Ex. Alcohol, barbiturates and benzodiazepines
16. Tolerance develops overtime and can develop tolerance to side
effects cross tolerance can occur between opioids: what are two
things to describe opioid tolerance?
17. Initial reaction occurs within 10 hours of discontinuation with
yawning, rhinorrhea, and sweating
-progresses to violent sneezing, nausea/vomiting/diarrhea, abdominal
cramps, bone, and muscle pain/spasm, and kicking movement
-lasts 7-10 days; uncomfortable but not lethal: what are the timeline and
symptoms of abrupt discontinuation of opioids after misuse?
18. Fentanyl (Duragesic, Abstral, Actiq, Fentora, Onsolis, Lazanda,
Subsys): an opioid agonist 100x stronger than morphine -given
parenteral, transdermal, or transmucosal
19. Methadone (Dolophine, Methadose): used for treatment of pain and
opioid
Misuse in which it's still opioids given in a more controlled way
-given day-by-day by clincis to prevent withdrawal or cravings
ANSWERS 2024 UPDATE
1. Analgesics: drugs that relieve pain without intentionally causing the
loss of consciousness
2. Opioid: a general term that is defined as any drug, natural or
synthetic, that has actions similar to those of morphine
-morphine is the original; everything funnels back to morphine
3. Opiate: a term that applies only to compounds present in opium 4.
Morphine and codeine: pure opioid agonists opioids that perpetuate a
response when it activates within a receptor to produce analgesia,
euphoria, sedations, respiratory depression, physical dependence,
constipation, etc.
Ex. Codeine converts to morphine when metabolized
5. About 5 days: how long does it take for physical dependence to
develop in a patient taking pure opioid agonists?
6. Pentazocine (Talwin)/buprenorphine (Butrans): agonist-antagonist
opioid class
Opioid medication class with the potential to both relieve pain and block
pain relief with opioid misuse
,-may be a good choice for opioid agonist discontinuation
7. If administered with a pure opioid agonist (ex. Oxycodone), it can
antagonize analgesia caused by the pure agonist
-given alone, will produce analgesia: what happens if you administer
pentazocine (Talwin) or buprenorphine (Butrans) with Oxycodone? 8.
Naloxone (Narcan): pure opioid antagonist medication that does not
produce analgesia or any of the other effects of opioids agonists
-reverses respiratory and CNS depression caused by overdose of opioid
agonist
9. Pain relief, anxiety reduction, sense of well-being
-side effects include drowsiness and mental cloudiness: what are the
three basic actions of morphine?
10. Morphine pharmacological actions: -respiratory depression -
constipation
-urinary retention
-orthostatic hypotension
-emesis
-miosis
-cough suppression
-biliary colic
,Tolerance and physical dependence within 5 days
11. Miosis: constricted pupils
12. Relieves pain without affecting the other senses by mimicking the
actions of endogenous opioid peptides primarily at mu receptors:
how does morphine therapeutically relieve pain?
13. Medications shouldn't be used for a time that would exceed the
time of the presenting pain
-if pain progresses, we need to look further into whether they're being
honest about their pain or what else could be causing the pain ex. If a
patient comes in with a broken leg, pain should last for approx. 3 days;
give the patient 3 days of opioids and then bridge to Ibuprofen: how
should NP's prescribe opioids to non-cancerous patients with no clear
guidelines?
14. Medication naive patients will only receive an opioid prescription
for 72 hours
-after they will need to come back in for re-evaluation for pain
management: what is the 72-hour window rule for opioid presciptions?
15. Do not combine opioid medication with other CNS depressant
actions -overview what medications the patient is already taking
, and educate them to not take both medications in the same
timeframe/window: what should we educate our patients on
regarding morphine and other CNS depressant medications?
Ex. Alcohol, barbiturates and benzodiazepines
16. Tolerance develops overtime and can develop tolerance to side
effects cross tolerance can occur between opioids: what are two
things to describe opioid tolerance?
17. Initial reaction occurs within 10 hours of discontinuation with
yawning, rhinorrhea, and sweating
-progresses to violent sneezing, nausea/vomiting/diarrhea, abdominal
cramps, bone, and muscle pain/spasm, and kicking movement
-lasts 7-10 days; uncomfortable but not lethal: what are the timeline and
symptoms of abrupt discontinuation of opioids after misuse?
18. Fentanyl (Duragesic, Abstral, Actiq, Fentora, Onsolis, Lazanda,
Subsys): an opioid agonist 100x stronger than morphine -given
parenteral, transdermal, or transmucosal
19. Methadone (Dolophine, Methadose): used for treatment of pain and
opioid
Misuse in which it's still opioids given in a more controlled way
-given day-by-day by clincis to prevent withdrawal or cravings
