NR 565 advanced pharmacology
midterm exam with over 240
questions and correct answers
What schedule is tramadol classified as?
schedule IV
What population should tramadol be AVOIDED in?
pt's with epilepsy, neurologic disorders, elderly
What drugs should be avoided for patients taking tramadol?
CNS depressants (benzo, alcohol), MAOI, SSRI, serotonin and norepinephrine
reuptake inhibitors, tricyclic antidepressants, triptans
What government branch declared the opioid crisis a public health
emergency?
Health and Human Services (HHS)
,what are the top 5 priorities of HHS?
Improving access to treatment and recovery services
Promoting use of overdose-reversing drugs
Strengthening our understanding of the epidemic through better public
health surveillance
Providing support for cutting edge research on pain and addiction
Advancing better practices for pain management
What were provisions made to the guidelines for prescribing opioids to non-
cancer patients?
Using opioids only after non-opioid analgesics or more conservative methods
have failed
Discussing the benefits and risks for long term opioids with patient
When possible, one prescriber, one pharmacy
Ensuring comprehensive follow up to assess efficacy and side effects of
treatment and monitor for signs of opioid abuse
Stopping opioids after an attempt at opioid rotation had produced
inadequate benefits
Fully documenting the entire process
When prescribing opioids should patient be initially started on IR or ER?
IR- lowest dose for shortest amount of time
How are patients initially exposed to opioids?
either recreationally (illicitly) or in context of pain management in medical
setting
,Which group of professionals are at greater risk for abusing?
health care providers, nurses, pharmacists
What are some effects of opioid use that DON'T change with long term use
and tolerance?
constipation and miosis (pupil constriction)
tolerance does develop?
euphoria, respiratory depression, and nausea
Is opioid withdrawal life threatening?
unpleasant but rarely dangerous
Methadone can be used for which two therapies?
maintenance- transferring addict from abuse opioid to oral methadone
suppressive- prevent the reinforcing effects of opioid induced euphoria
Methadone half life?
long, prescribed only by providers with special training in pain management
, Does methadone or buprenorphine have a ceiling (drugs that impact on body
plateus) to respiratory depression?
buprenorphine - makes it safer
What are the therapeutic uses for morphine?
pain management, sedation, euphoria, respiratory depression, cough
suppression, reduces anxiety, a sense of well-being, suppress GI motility
(help with severe diarrhea)
Therapeutic uses of fentanyl?
Chronic or acute severe pain, cancer pain
Risk factors for opioid use disorder
chronic pain, family history, other substance abuse, prescribed for long term
use
Drugs not safe to take with opioids
opioids, benzos, alcohol, CNS depressants, anti-histamines, general
anesthetics
Buprenorzhine and Naloxone
agonist-antagonist
midterm exam with over 240
questions and correct answers
What schedule is tramadol classified as?
schedule IV
What population should tramadol be AVOIDED in?
pt's with epilepsy, neurologic disorders, elderly
What drugs should be avoided for patients taking tramadol?
CNS depressants (benzo, alcohol), MAOI, SSRI, serotonin and norepinephrine
reuptake inhibitors, tricyclic antidepressants, triptans
What government branch declared the opioid crisis a public health
emergency?
Health and Human Services (HHS)
,what are the top 5 priorities of HHS?
Improving access to treatment and recovery services
Promoting use of overdose-reversing drugs
Strengthening our understanding of the epidemic through better public
health surveillance
Providing support for cutting edge research on pain and addiction
Advancing better practices for pain management
What were provisions made to the guidelines for prescribing opioids to non-
cancer patients?
Using opioids only after non-opioid analgesics or more conservative methods
have failed
Discussing the benefits and risks for long term opioids with patient
When possible, one prescriber, one pharmacy
Ensuring comprehensive follow up to assess efficacy and side effects of
treatment and monitor for signs of opioid abuse
Stopping opioids after an attempt at opioid rotation had produced
inadequate benefits
Fully documenting the entire process
When prescribing opioids should patient be initially started on IR or ER?
IR- lowest dose for shortest amount of time
How are patients initially exposed to opioids?
either recreationally (illicitly) or in context of pain management in medical
setting
,Which group of professionals are at greater risk for abusing?
health care providers, nurses, pharmacists
What are some effects of opioid use that DON'T change with long term use
and tolerance?
constipation and miosis (pupil constriction)
tolerance does develop?
euphoria, respiratory depression, and nausea
Is opioid withdrawal life threatening?
unpleasant but rarely dangerous
Methadone can be used for which two therapies?
maintenance- transferring addict from abuse opioid to oral methadone
suppressive- prevent the reinforcing effects of opioid induced euphoria
Methadone half life?
long, prescribed only by providers with special training in pain management
, Does methadone or buprenorphine have a ceiling (drugs that impact on body
plateus) to respiratory depression?
buprenorphine - makes it safer
What are the therapeutic uses for morphine?
pain management, sedation, euphoria, respiratory depression, cough
suppression, reduces anxiety, a sense of well-being, suppress GI motility
(help with severe diarrhea)
Therapeutic uses of fentanyl?
Chronic or acute severe pain, cancer pain
Risk factors for opioid use disorder
chronic pain, family history, other substance abuse, prescribed for long term
use
Drugs not safe to take with opioids
opioids, benzos, alcohol, CNS depressants, anti-histamines, general
anesthetics
Buprenorzhine and Naloxone
agonist-antagonist
