NSG 533 Pharm Exam 2
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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 >3,000mg per day of
acetaminophen.
,What medication could you recommend for a diabetic patient in pain
that could also be used to help treat depression? - Answer: SNRIs;
either duloxetine or venlafaxine have been successfully used in diabetic
peripheral neuropathy.
In addition, be sure to understand which non-opiod medications you
would use for a patient with neuropathic pain. - Answer: Gabapentin,
pregabalin, transdermal lidocaine, TCAs.
If a patient has a true allergy to morphine, what opioid, if any, could
you try instead? - Answer: True opioid allergies are rare. When a true
allergy is present, an agent from another opiate classed should be used.
For example, a patient with a true opiate allergy could receive fentanyl.
Know the common side effects which opioids can cause: - Answer:
Excessive sedation (reduce dose by 25%), constipation (senna, dulcolax,
N/V (hydroxyzine/ diphenhydramine), gastroparesis, vertigo, resp.
depression, CNS irritability.
Know the WHO pain treatment algorithm: - Answer: Mild pain (1-3)
non-opioid analgesic scheduled ATC
Moderate pain (4-6) Add opioid to scheduled non-opioid ATC
Severe pain (7-10) Switch to high dose opioid, ATC
, Understand when you would use acetaminophen versus an NSAID or an
NSAID instead of acetaminopehn - Answer: NSAIDs work best on
inflammatory pain or pain mediated by prostaglandins (RA, menstrual
and post-surgical pain) and bony metastasis. NSAIDS come with
increased GIB risk and renal impairment.
APAP is a good first line for mild to moderate pain and considered the
first line in low back pain and osteoarthritic. APAP hepatotoxicity has
occured in those w. liver injury or chronic drinkers.
What class of prophylaxis for migraines should be avoided in
asthmatics? - Answer: Beta blockers would usually be a medication
used in the prophylaxis of migraines but this would not be the best
choice in an asthmatic.
What could you use for prophylaxis of migraines? - Answer: -beta-
blockers if not contraindicated (or CCB)
-low-dose TCAs (amitriptyline, venlafaxine)
-antiepileptics (topiramate, valproic acid, divalproex sodium)
Comprehensive Questions
(Frequently Tested) with Verified
Answers Graded A+
Professional Academic Assistance Services
Services Offered
• Proctored Exam Assistance
• Online Class Management (Full Course Support)
• Exam Preparation & Study Materials
• Assignments and Coursework Support
• Essay and Research Paper Writing
• Discussion Posts & Responses
• Editing and Proofreading
• Confidential Academic Consultation
Helping Students Achieve Academic Excellence
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 >3,000mg per day of
acetaminophen.
,What medication could you recommend for a diabetic patient in pain
that could also be used to help treat depression? - Answer: SNRIs;
either duloxetine or venlafaxine have been successfully used in diabetic
peripheral neuropathy.
In addition, be sure to understand which non-opiod medications you
would use for a patient with neuropathic pain. - Answer: Gabapentin,
pregabalin, transdermal lidocaine, TCAs.
If a patient has a true allergy to morphine, what opioid, if any, could
you try instead? - Answer: True opioid allergies are rare. When a true
allergy is present, an agent from another opiate classed should be used.
For example, a patient with a true opiate allergy could receive fentanyl.
Know the common side effects which opioids can cause: - Answer:
Excessive sedation (reduce dose by 25%), constipation (senna, dulcolax,
N/V (hydroxyzine/ diphenhydramine), gastroparesis, vertigo, resp.
depression, CNS irritability.
Know the WHO pain treatment algorithm: - Answer: Mild pain (1-3)
non-opioid analgesic scheduled ATC
Moderate pain (4-6) Add opioid to scheduled non-opioid ATC
Severe pain (7-10) Switch to high dose opioid, ATC
, Understand when you would use acetaminophen versus an NSAID or an
NSAID instead of acetaminopehn - Answer: NSAIDs work best on
inflammatory pain or pain mediated by prostaglandins (RA, menstrual
and post-surgical pain) and bony metastasis. NSAIDS come with
increased GIB risk and renal impairment.
APAP is a good first line for mild to moderate pain and considered the
first line in low back pain and osteoarthritic. APAP hepatotoxicity has
occured in those w. liver injury or chronic drinkers.
What class of prophylaxis for migraines should be avoided in
asthmatics? - Answer: Beta blockers would usually be a medication
used in the prophylaxis of migraines but this would not be the best
choice in an asthmatic.
What could you use for prophylaxis of migraines? - Answer: -beta-
blockers if not contraindicated (or CCB)
-low-dose TCAs (amitriptyline, venlafaxine)
-antiepileptics (topiramate, valproic acid, divalproex sodium)
