Pain Management

Descripción

Test sobre Pain Management, creado por Maggie Throckmorton el 04/12/2017.
Maggie Throckmorton
Test por Maggie Throckmorton, actualizado hace más de 1 año
Maggie Throckmorton
Creado por Maggie Throckmorton hace casi 7 años
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Resumen del Recurso

Pregunta 1

Pregunta
Neuropathic pain is abnormal signal processes in the CNS and can be peripheral and [blank_start]central[blank_end]
Respuesta
  • central

Pregunta 2

Pregunta
Examples of peripheral neuropathic pain include (select all that apply):
Respuesta
  • Lumbar radiculopathy
  • Peripheral neuropathy with DM
  • Postherpetic Neuralgia

Pregunta 3

Pregunta
A example of central neuropathic pain is fibromyalgia.
Respuesta
  • True
  • False

Pregunta 4

Pregunta
Opioid therapy is not a [blank_start]1st[blank_end] line treatment for neuropathic pain.
Respuesta
  • 1st

Pregunta 5

Pregunta
An example of nociceptive pain is tissue [blank_start]damage[blank_end].
Respuesta
  • damage

Pregunta 6

Pregunta
There are two types of nociceptive pain, [blank_start]somatic[blank_end] which includes muscle, skin and bones and [blank_start]visceral[blank_end] which includes organs.
Respuesta
  • somatic
  • visceral

Pregunta 7

Pregunta
Acute pain is defined as (select all that apply):
Respuesta
  • Sudden, usually an identifiable cause, less than 3 months in duration
  • Usually a response to injury
  • Usually nociceptive in nature

Pregunta 8

Pregunta
Chronic pain (select all that apply):
Respuesta
  • lasts longer than 3 months
  • is non-cancer pain
  • Is cancer pain
  • is breakthrough pain

Pregunta 9

Pregunta
T or F. The WHO analgesic ladder recommends non-opioids in the treatment of mild pain.
Respuesta
  • True
  • False

Pregunta 10

Pregunta
The WHO analgesic ladder recommends the use of opioids along with non-opioid and adjuvant treatments in treating [blank_start]mild[blank_end] to [blank_start]moderate[blank_end] pain.
Respuesta
  • mild
  • moderate

Pregunta 11

Pregunta
The 1st line treatment for mild to [blank_start]moderate[blank_end] pain is Acetaminophen and NSAIDS.
Respuesta
  • moderate

Pregunta 12

Pregunta
T or F. Use the max dose of acetiminophen or NSAIDS before proceeding to analgesics.
Respuesta
  • True
  • False

Pregunta 13

Pregunta
T or F. Acetaminophen generally has a favorable side effect profile.
Respuesta
  • True
  • False

Pregunta 14

Pregunta
Two considerations in using NSAIDS are patients with a history of CV disease and [blank_start]GI[blank_end] bleeding.
Respuesta
  • GI

Pregunta 15

Pregunta
Acetaminophen is best for patients with non-inflammatory [blank_start]pain[blank_end] like Osteoarthritis and chronic low back pain.
Respuesta
  • pain

Pregunta 16

Pregunta
T or F. Acetaminophen does not alter platelet functioning.
Respuesta
  • True
  • False

Pregunta 17

Pregunta
Acetaminophen is known to be hepatoxic and can impact [blank_start]liver[blank_end] function.
Respuesta
  • liver

Pregunta 18

Pregunta
There is caution in using acetaminophen in patients with a history of ETOH abuse and hepatic dysfunction.
Respuesta
  • True
  • False

Pregunta 19

Pregunta
Acetaminophen interacts with warfarin/coumadin and prolongs [blank_start]INR[blank_end].
Respuesta
  • INR

Pregunta 20

Pregunta
Acetaminophen is the drug of choice as an analgesic and antypyretic in (select all that apply):
Respuesta
  • Pregnant women
  • Lactating women

Pregunta 21

Pregunta
NSAIDS have [blank_start]anti-inflammatory[blank_end] and analgesic properties.
Respuesta
  • anti-inflammatory

Pregunta 22

Pregunta
Prescription examples of NSAIDS like Naprosyn has a more [blank_start]rapid[blank_end] onset and Meloxicam has a [blank_start]longer[blank_end] duration of action.
Respuesta
  • rapid
  • longer

Pregunta 23

Pregunta
T or F. NSAIDS are effective treatment for acute and chronic pain and inflammatory conditions.
Respuesta
  • True
  • False

Pregunta 24

Pregunta
GI concerns with the [blank_start]use[blank_end] of NSAIDS includes dyspepsia, ulceration and bleeding.
Respuesta
  • use

Pregunta 25

Pregunta
T or F. Selective COX 2 inhibitors have less GI Risk.
Respuesta
  • True
  • False

Pregunta 26

Pregunta
Safety concerns and considerations with NSAID with CV disease or thrombotic events include (select all that apply):
Respuesta
  • Nonselective NSAIDs reversibly inhibit platelet function.
  • NSAIDS interfere with the cardioprotective effect of aspirin
  • Naproxen may have less CV toxicity than comparable doses of other NSAIDS.

Pregunta 27

Pregunta
In patients with or at risk for CV disease, NSAIDS should be [blank_start]avoided[blank_end], or, if benefits outweigh risks, use at the [blank_start]lowest[blank_end] effective dose, for the [blank_start]shortest[blank_end] duration necessary.
Respuesta
  • avoided
  • lowest
  • shortest

Pregunta 28

Pregunta
T or F. NSAIDS should be avoided in older adults and in pregnancy.
Respuesta
  • True
  • False

Pregunta 29

Pregunta
NSAIDS monitoring should include (select all that apply):
Respuesta
  • Renal function
  • Edema
  • Blood pressure
  • Hgb and Hct

Pregunta 30

Pregunta
In some psych patients, NSAIDS may [blank_start]increase[blank_end] lithium levels.
Respuesta
  • increase

Pregunta 31

Pregunta
NSAIDS should also be avoided in patients with a history of (select all that apply):
Respuesta
  • Uncontrolled HTN
  • Renal insufficiency
  • GI Bleed
  • Platelet dysfunction
  • Reduced cardiac output
  • Cirrhosis
  • History of Venous Thrombosis

Pregunta 32

Pregunta
T or F. NSAIDS may cause or worsen renal impairment.
Respuesta
  • True
  • False

Pregunta 33

Pregunta
Indomethacin (Indocin) is an NSAID that is used in the treatment of acute [blank_start]gout[blank_end] and specific types of headaches.
Respuesta
  • gout

Pregunta 34

Pregunta
T or F. The MOA for Indomethacin is a potent inhibitory effect on renal prostaglandin synthesis.
Respuesta
  • True
  • False

Pregunta 35

Pregunta
Indomethacin has more frequent [blank_start]CNS[blank_end] side effects and has a higher risk of renal and CV toxicities.
Respuesta
  • CNS

Pregunta 36

Pregunta
T or F. Sulindac (Clinoril) is an NSAID which cause more frequent hepatic inflammation, can contribute to the formation of renal calculi and the prescribing of this drug should be limited to specialists.
Respuesta
  • True
  • False

Pregunta 37

Pregunta
Ketorolac is used for moderate pain, comes in tablets or injection and carries a BBW for short term use, less than [blank_start]five[blank_end] days in adults.
Respuesta
  • five

Pregunta 38

Pregunta
Contraindications and cautions in the use of Ketorolac include (select all that apply):
Respuesta
  • GI
  • CV
  • Renal
  • Bleeding
  • Labor and Delivery

Pregunta 39

Pregunta
T or F. Oral Ketorolac is not indicated in pediatrics.
Respuesta
  • True
  • False

Pregunta 40

Pregunta
Topical NSAIDS have a [blank_start]lower[blank_end] risk for systemic effects.
Respuesta
  • lower

Pregunta 41

Pregunta
T or F. Diclofenac (Voltaren) gel is helpful in the relief of OA pain.
Respuesta
  • True
  • False

Pregunta 42

Pregunta
Flector, an NSAID patch is helpful in [blank_start]acute[blank_end] pain due to minor strains, sprains and contusions.
Respuesta
  • acute

Pregunta 43

Pregunta
The MOA of topical lidocaine for pain is blocking the initiation and conduction of [blank_start]nerve[blank_end] impulses.
Respuesta
  • nerve

Pregunta 44

Pregunta
T or F. Topical lidocaine is best for neuropathic, local and OA pain.
Respuesta
  • True
  • False

Pregunta 45

Pregunta
Adverse effects of topical lidocaine include local [blank_start]skin[blank_end] irritation.
Respuesta
  • skin

Pregunta 46

Pregunta
T or F. There is a low risk for systemic side effects if topical lidocaine is used properly.
Respuesta
  • True
  • False

Pregunta 47

Pregunta
The following is true of steroid therapy for pain (select all that apply):
Respuesta
  • Has anti-inflammatory properties
  • Evidence shows little to no benefit
  • Are not generally 1st line
  • Can be considered short term if refractory to NSAIDS.

Pregunta 48

Pregunta
A taper is required if steroids like Prednisone or Medrol dose pack are used for more than [blank_start]two[blank_end] weeks.
Respuesta
  • two

Pregunta 49

Pregunta
T or F. Cortisone can be given as an IM injection and has a short-acting duration of 2-3 days.
Respuesta
  • True
  • False

Pregunta 50

Pregunta
Triamcinolone(Kenalog) [blank_start]and[blank_end] Methylprednisolone (Depo-Medrol) have an intermediate potency and duration.
Respuesta
  • and

Pregunta 51

Pregunta
Dexamethasone/Decadron has a [blank_start]high[blank_end] potency and long-acting duration up to about [blank_start]ten[blank_end] days.
Respuesta
  • high
  • ten

Pregunta 52

Pregunta
T or F. Steroid injections in joints for pain, must be done by a trained provider.
Respuesta
  • True
  • False

Pregunta 53

Pregunta
Major side effects associated with the use of systemic glucocorticoids is often [blank_start]dose[blank_end] -dependent and more likely to occur with [blank_start]long[blank_end]-term use.
Respuesta
  • dose
  • long

Pregunta 54

Pregunta
Systemic glucocorticoids can cause elevated [blank_start]blood[blank_end] pressure, mood disorders, psychosis, insomnia, and impact blood sugar by causing hyerglycemia.
Respuesta
  • blood

Pregunta 55

Pregunta
Additional major side effects associated with the use of systemic glucocorticoids includes (select all that apply):
Respuesta
  • Gastritis
  • Ulcer formation
  • GI Bleeding
  • Bone loss
  • Heightened risk of typical infections

Pregunta 56

Pregunta
Muscle relaxants used for pain are to be used short-term for less than [blank_start]two[blank_end] weeks, and should be avoided in patients older than [blank_start]65[blank_end] years.
Respuesta
  • two
  • 65

Pregunta 57

Pregunta
The main adverse effect of muscle relaxants for pain is [blank_start]sedation[blank_end].
Respuesta
  • sedation

Pregunta 58

Pregunta
T or F. Antispasmodic skeletal muscle relaxants are indicated in the treatment of acute cervical or lumbar pain.
Respuesta
  • True
  • False

Pregunta 59

Pregunta
Cyclobenzaprine (Flexeril) is not [blank_start]controlled[blank_end] and can be dosed up to [blank_start]three[blank_end] times a day if needed.
Respuesta
  • controlled
  • three

Pregunta 60

Pregunta
T or F. Tizanidine (Zanaflex) is an Alpha 2 adrenergic agonist.
Respuesta
  • True
  • False

Pregunta 61

Pregunta
Carisoprodol (Soma) is a [blank_start]controlled[blank_end] substance that can cause respiratory [blank_start]depression[blank_end] and physical and psycholgic [blank_start]dependence[blank_end].
Respuesta
  • controlled
  • dependence
  • depression

Pregunta 62

Pregunta
Treatment options for chronic pain include (select all that apply):
Respuesta
  • Pharmacologic
  • Physical medicine like PT and massage
  • Behavioral medicine (CBT and biofeedback)
  • Neuromodulation (TENS and spinal cord stimulation)
  • Interventional (Percutaneous injections of glucocorticoid and/or local anesthetic
  • Surgery (spinal fusion for example)

Pregunta 63

Pregunta
Treatment of chronic pain should be a multidisciplinary effort, using multiple approaches and collaborative care models to improve pain management and patient [blank_start]outcomes[blank_end].
Respuesta
  • outcomes

Pregunta 64

Pregunta
[blank_start]Medication[blank_end] should not be the sole focus of treatment, but should be used when according to evidence-ased recommendations to meet treatment goals and in conjunction with other treatment modalities.
Respuesta
  • Medication

Pregunta 65

Pregunta
T or F. Adjuvants for chronic pain include anticonvulsants and antidepressants; they enhance analgesia and manage other symptoms associated with pain like depression and anxiety.
Respuesta
  • True
  • False

Pregunta 66

Pregunta
Gabapentin (Neurontin) and pregablin (Lyrica) have proven efficacy versus placebo in several neuropathic [blank_start]pain[blank_end] conditions.
Respuesta
  • pain

Pregunta 67

Pregunta
Adverse effects of anticonvulsants like gabapentin and pregabalin for pain include [blank_start]dizziness[blank_end] and sedation.
Respuesta
  • dizziness

Pregunta 68

Pregunta
T or F. When using anticonvulsants as an adjuvant in pain management, start it with a low dose with gradual increases until pain relief.
Respuesta
  • True
  • False

Pregunta 69

Pregunta
Pregabalin is controlled , reported to cause [blank_start]euphoria[blank_end] and is a Schedule [blank_start]V[blank_end].
Respuesta
  • euphoria
  • V

Pregunta 70

Pregunta
T or F. There are some reports of misuse with gabapentin.
Respuesta
  • True
  • False

Pregunta 71

Pregunta
Venlafaxine (Effexor) and Duloxetine (Cymbalta) are [blank_start]SNRI's[blank_end] that may provide [blank_start]pain[blank_end] relief separate from their anti-depressant effect.
Respuesta
  • SNRI's
  • pain

Pregunta 72

Pregunta
T or F. The analgesic effects of SNRI's appear to occure early and at lower doses.
Respuesta
  • True
  • False

Pregunta 73

Pregunta
SNRI's are helpful treating pain from [blank_start]diabetic[blank_end] neuropathy, fibromyalgia and chronic musculoskeletal pain.
Respuesta
  • diabetic

Pregunta 74

Pregunta
T or F. SNRI's would have to be tapered gradually to avoid withdrawal symptoms.
Respuesta
  • True
  • False

Pregunta 75

Pregunta
[blank_start]TCA's[blank_end] like amitriptyline (Elavil) are associated with multiple side-effects and do not carry a indication for [blank_start]pain[blank_end] management.
Respuesta
  • TCA's
  • pain

Pregunta 76

Pregunta
In patients with chronic kidney disease and the elderly avoid [blank_start]NSAIDS[blank_end] and COX 2 inhibitors like Celebrex.
Respuesta
  • NSAIDS

Pregunta 77

Pregunta
T or F. Avoid NSAIDS with peptic ulcer disease and glucocorticoid use.
Respuesta
  • True
  • False

Pregunta 78

Pregunta
In patients with cardiovascular disease or risk, use the lowest effective dose of NSAIDS; in patients who require treatment consider [blank_start]naproxen[blank_end].
Respuesta
  • naproxen

Pregunta 79

Pregunta
Opioids are indicated for moderate to [blank_start]severe[blank_end] pain, are controlled drugs and powerful analgesics.
Respuesta
  • severe

Pregunta 80

Pregunta
T or F. When combined with acetaminophen and ibuprofen, opioids provide better pain control than if they are used alone.
Respuesta
  • True
  • False

Pregunta 81

Pregunta
Opioids are [blank_start]Mu[blank_end] receptor agonists.
Respuesta
  • Mu

Pregunta 82

Pregunta
Mu1 [blank_start]receptors[blank_end] correlate to supraspinal analgesia, bradycardia and sedation.
Respuesta
  • receptors

Pregunta 83

Pregunta
Mu2 [blank_start]receptors[blank_end] correlate to respiratory depression, euphoria and physical dependence
Respuesta
  • receptors

Pregunta 84

Pregunta
Delta [blank_start]receptors[blank_end] correlate to spinal analgesia and respiratory depression.
Respuesta
  • receptors

Pregunta 85

Pregunta
Kappa [blank_start]receptors[blank_end] correlate to spinal analgesia, respiratory depression and sedation.
Respuesta
  • receptors

Pregunta 86

Pregunta
Higher potency opioids like morphine, hydromorphone and fentanyl are reserved for [blank_start]severe[blank_end] pain.
Respuesta
  • severe

Pregunta 87

Pregunta
Literature suggests opioids should only be used on a chronic basis in patients (select all that apply):
Respuesta
  • Have persistent pain despite trials of non-opioid analgesics and other options
  • Are at low risk for substance abuse
  • Should be referred to a pain management specialist.

Pregunta 88

Pregunta
Tramadol (Ultram) is a centrally acting weak [blank_start]agonist[blank_end] of opioid receptors which also inhibits the reuptake of norepinephrine and causes [blank_start]serotonin[blank_end] release.
Respuesta
  • agonist
  • serotonin

Pregunta 89

Pregunta
T or F. Ultram is a Schedule IV controlled substance and has a higher risk for drug interaction due to hepatic metabolism due to CYP-450.
Respuesta
  • True
  • False

Pregunta 90

Pregunta
Adverse effects of tramadol (Ultram) include (select all that apply):
Respuesta
  • Sedation
  • Seizures
  • Serotonin Syndrome
  • Increased risk for suicide in patients with mental health disorders

Pregunta 91

Pregunta
Tramadol (Ultram) should be avoided in patients with a history of [blank_start]addiction[blank_end] or substance abuse and is not FDA approved for [blank_start]pediatric[blank_end] use.
Respuesta
  • addiction
  • pediatric

Pregunta 92

Pregunta
T or F. Tramadol (Ultram) would need to be tapered if discontinuing after prolonged use.
Respuesta
  • True
  • False

Pregunta 93

Pregunta
Current evidence supports the role of opioid therapy in more severe forms of [blank_start]acute[blank_end] pain and in [blank_start]cancer[blank_end] pain.
Respuesta
  • acute
  • cancer

Pregunta 94

Pregunta
There is limited evidence for effectiveness of [blank_start]long[blank_end]-term opioid therapy for pain relief and improved functional outcomes.
Respuesta
  • long

Pregunta 95

Pregunta
T or F. Opioid administration in chronic non-cancer pain remains controversial.
Respuesta
  • True
  • False

Pregunta 96

Pregunta
Adverse effects of opioids include sedation and the highest risk for respiratory depression is in opioid [blank_start]naive[blank_end] patients.
Respuesta
  • naive

Pregunta 97

Pregunta
There is a higher risk for [blank_start]respiratory[blank_end] depression in the elderly, COPD and severe asthma.
Respuesta
  • respiratory

Pregunta 98

Pregunta
Additional adverse effects of opioids includes (select all that apply):
Respuesta
  • Euphoria/Dysphoria
  • Dyspepsia
  • Itching due to histamine release
  • Urinary retention
  • Constipation
  • Hyperalgesia-nociceptive sensitization (increased pain)
  • Decreased libido (increase prolactin, decreased cortisol, LH, FSH, estrogen and testosterone)

Pregunta 99

Pregunta
Opioid overdose [blank_start]risk[blank_end] increases with increased dosing.
Respuesta
  • risk

Pregunta 100

Pregunta
The most common opioids involved in overdose deaths include (select all that appy):
Respuesta
  • Hydrocodone (Vicodin)
  • Oxycodone (Oxycontin)
  • Oxymorphone (Opana)
  • Methadone

Pregunta 101

Pregunta
Benzodiazepines and opioids should [blank_start]not[blank_end] be co-prescribed.
Respuesta
  • not

Pregunta 102

Pregunta
T or F. Between 1999-2003, adults ages 25-54 had the highest overdose rates.
Respuesta
  • True
  • False

Pregunta 103

Pregunta
Opioid naive patients have the [blank_start]highest[blank_end] risk for overdose death in the first two weeks of treatment and are defined as patients who have not received opioids for one week or longer at doses defined by the FDA for tolerance.
Respuesta
  • highest

Pregunta 104

Pregunta
According to the FDA, patients who are opioid-tolerant have been taking opioids for a 1 [blank_start]week[blank_end] or longer in the following doses: at least 60mg of oral morphine QD, 25 mcg of transdermal fentanyl per hour, 30 mg oral oxycodone QD, 8 mg hydromorphone QD, 25 mg of oxymorphone QD or an equianalgesic dose of another opioid.
Respuesta
  • week

Pregunta 105

Pregunta
Equianlagesic dosing is defined as the dose in [blank_start]steady[blank_end] state providing the same analgesic response also know as morphine equivalent dosing.
Respuesta
  • steady

Pregunta 106

Pregunta
T or F. Morphine is the gold standard for comparison of all pain relieving meds and serves as a reference point for analgesic potency.
Respuesta
  • True
  • False

Pregunta 107

Pregunta
T or F. Morphine 30mg PO is equivalent to hydromorphone 7.5 mg PO.
Respuesta
  • True
  • False

Pregunta 108

Pregunta
There is substantial interpatient variability in relative potency of different opioid [blank_start]drugs[blank_end].
Respuesta
  • drugs

Pregunta 109

Pregunta
When changing from one opioid to another, it is preferable to consider initially underestimating requirements and provide rescue medication as needed to [blank_start]avoid[blank_end] potentially fatal overdose.
Respuesta
  • avoid

Pregunta 110

Pregunta
T or F. The elderly are more susceptible to the adverse effects of opioids and the NP should consider starting at 1/2 the typical starting dose.
Respuesta
  • True
  • False

Pregunta 111

Pregunta
Opioids should not be prescribed in [blank_start]pregnancy[blank_end].
Respuesta
  • pregnancy

Pregunta 112

Pregunta
Neonatal abstinence syndrome presents as irritability, hyperactivity, abnormal sleep patterns, high pitched [blank_start]cry[blank_end], tremor, vomiting, diarrhea and failure to gain weight.
Respuesta
  • cry

Pregunta 113

Pregunta
T or F. Pregnant women who are dependent on opioids should be referred to a specialist who will likely place them on methadone or buprenorphine.
Respuesta
  • True
  • False

Pregunta 114

Pregunta
Dependence is the emergence of withdrawal symptoms when the drug is abruptly discontinued or the dose is rapidly decreased, and usually occurs after taking the drug for [blank_start]one[blank_end] month or longer.
Respuesta
  • one

Pregunta 115

Pregunta
T or F. Dependence is a component of addiction, but not all patients with dependence are addicts.
Respuesta
  • True
  • False

Pregunta 116

Pregunta
Opioid withdrawal signs and symptoms include (select all that apply)
Respuesta
  • Diaphoresis
  • HTN
  • Tachycarida
  • Lacrimation
  • Shivering
  • Piloerection
  • N/V/D
  • Rhinorrhea
  • Sleeplessness
  • Restlessness

Pregunta 117

Pregunta
T or F. Additional symptoms of opioid withdrawal include tremors, dysphoria, anxiety, mood volatility, abdominal cramping, bone pains and diffuse muscle aches, as well as strong drug cravings.
Respuesta
  • True
  • False

Pregunta 118

Pregunta
Tolerance is defined as increasing amounts of opioid [blank_start]are[blank_end] required to produce an equivalent level of efficacy.
Respuesta
  • are

Pregunta 119

Pregunta
T or F. Tolerance typically does not develop in patient with cancer who are treated for pain.
Respuesta
  • True
  • False

Pregunta 120

Pregunta
Addiction is characterized as a psychological and behavioral syndrome, with extreme behavior patterns that are associated with procuring and consuming the [blank_start]drug[blank_end].
Respuesta
  • drug

Pregunta 121

Pregunta
Features of opioid addiction include (select all that apply):
Respuesta
  • Drug craving
  • Compulsive use
  • Strong tendency to relapse after withdrawal

Pregunta 122

Pregunta
Maladaptive behavior associated with addiction include (select all that apply):
Respuesta
  • Adverse consequences due to drug use
  • Loss of control over drug use
  • Preoccupation with obtaining opioids

Pregunta 123

Pregunta
Prescription drug [blank_start]misuse[blank_end] is using the prescribed drug outside of the intent for which it was prescribed and includes using to "get high". having multiple prescribers or non-prescribed sources for the medication, and concurrent use of alcohol, illicit substances or non-prescribed opioid controlled medications.
Respuesta
  • misuse

Pregunta 124

Pregunta
Risk factors associated with increased risk for opioid misuse include (select all that apply):
Respuesta
  • Personal or family history of substance use disorder
  • Mental health disorder, to include depression or PTSD
  • History of legal problems or incarceration
  • Age less than 40-45 years old

Pregunta 125

Pregunta
Aberrant behaviors associated with addiction include (select all that apply):
Respuesta
  • Doctor shopping
  • Diversion
  • Failure to comply with dosing instructions
  • Use of other illicit drugs or controlled substances that are not prescribed.

Pregunta 126

Pregunta
The DSM-5 definition of Opioid Use Disorder is a problematic pattern of opioid use leading to clinically significant impairment of distress, as manifested by at least [blank_start]2[blank_end] specific behaviors in a [blank_start]12[blank_end] month period: larger amounts/longer period; persistent desire for opioid; spending excessive time to obtain, use or recover from the effects of opioids.
Respuesta
  • 2
  • 12

Pregunta 127

Pregunta
[blank_start]Medication[blank_end] Assisted Treatment or MAT, may be used to treat opioid use disorder and includes naltrexone (mild d./o). buprenorphine and methadone (moderate to severe) and naloxone (mild, moderate, severe)
Respuesta
  • Medication

Pregunta 128

Pregunta
Indications for tapering in chronic opioid therapy include (select all that apply):
Respuesta
  • Violation of pain contract/abberant drug related behaviors
  • Lack of progress toward therapeutic goals
  • Intolerable adverse effects

Pregunta 129

Pregunta
When tapering opioids, it is recommended to reduce the dose by [blank_start]10[blank_end]% each week.
Respuesta
  • 10

Pregunta 130

Pregunta
T or F. Clonidine can be used to treat the diarrhea and muscle pain associated with opiate withdrawal and Zolpidem or Doxepin for sleep issues.
Respuesta
  • True
  • False

Pregunta 131

Pregunta
Methadone is a long-acting synthetic opioid [blank_start]agonist[blank_end] with dual-mechanism on the Mu and NMDA receptor, and is a Schedule [blank_start]II[blank_end] controlled substance.
Respuesta
  • II
  • agonist

Pregunta 132

Pregunta
The following is true of methadone (select all that apply):
Respuesta
  • Is reserved as an advanced therapy for severe pain when other conventional therapies fail
  • Is highly regulated and only available at specialized clinics
  • Is difficult to dose, potenitally lethal in overdose
  • Has many drug interactions and adverse reactions

Pregunta 133

Pregunta
Buprenorphine is a [blank_start]synthetic[blank_end] opioid, used for severe pain (just an FYI, our doctors at my hospital say it is illegal to prescribe it for pain) and opioid dependence and is considered a partial Mu-opioid [blank_start]agonist[blank_end] and is a Schedule [blank_start]III[blank_end] controlled substance.
Respuesta
  • synthetic
  • agonist
  • III

Pregunta 134

Pregunta
T or F. Buprenorphine can only be prescribed by specially trained MD's and NP.
Respuesta
  • True
  • False

Pregunta 135

Pregunta
T or F. Buprenorphine combined with the antagonist naloxone is called Suboxone.
Respuesta
  • True
  • False

Pregunta 136

Pregunta
T or F. There are critical opioid interactions with CNS depressants and alcohol.
Respuesta
  • True
  • False

Pregunta 137

Pregunta
T or F. Many drugs can inhibit or induce the metabolism of opioids and raise or lower serum opioid levels, leading to increase risk for respiratory depression or sedation, or cause the development of withdrawal symptoms.
Respuesta
  • True
  • False

Pregunta 138

Pregunta
The following drugs may induce the metabolism of opioids (select all that apply)
Respuesta
  • St. John's Wort
  • Phenobarbital
  • Phenytonin
  • Rifampin

Pregunta 139

Pregunta
T or F. Naloxone (Narcan) competitively binds to opioid receptors without producing analgesic response.
Respuesta
  • True
  • False

Pregunta 140

Pregunta
Pain medications that are scheduled include (select all that apply):
Respuesta
  • Opioids
  • Lyrica (Pregabaliin)
  • Soma (Carisoprodol)
  • Fioricet with codiene

Pregunta 141

Pregunta
Schedule [blank_start]I[blank_end] drugs have no currently accepted medical use in the US and have a high potential for abuse.
Respuesta
  • I

Pregunta 142

Pregunta
Schedule [blank_start]II[blank_end] drugs have a high potential for abuse, which may lead to severe psychological or physical dependence, can only be prescribed with a max [blank_start]30[blank_end] day quantity, no refills, no [blank_start]verbal[blank_end] orders (hard copy of the Rx required).
Respuesta
  • II
  • 30
  • verbal

Pregunta 143

Pregunta
Schedule [blank_start]III[blank_end] drugs have a potential for abuse less than substances in Schedules I/II, and abuse may lead to moderate or low physical depedence or high psychological dependene, can prescibe a max [blank_start]6[blank_end] month supply and verbal orders are allowed.
Respuesta
  • III
  • 6

Pregunta 144

Pregunta
Schedule [blank_start]IV[blank_end] drugs have a low potential for abuse relative to the substances in Schedule III, can have a max 6 month supply, verbal orders are [blank_start]allowed[blank_end] and includes several benzodiazipines like Xanax, Kolnopin and Valium.
Respuesta
  • IV
  • allowed

Pregunta 145

Pregunta
Schedule [blank_start]V[blank_end] drugs have a low potential for abuse relative to substances listed in Schedule IV and consist primarily of preparations containing limited quantities of certain narcotics, like cough preparations with codeine.
Respuesta
  • V

Pregunta 146

Pregunta
The five A' s framework for follow-up of patients prescribed chronic opioids includes (select all that apply):
Respuesta
  • Analgesia
  • ADL's and assessment of functional status
  • Addiction
  • Adverse effects
  • Adherence to treatment plan

Pregunta 147

Pregunta
T or F. Urine Drug Testing can be used to determine if the patient is taking the controlled substance as prescribed and/or if the patient is taking other drugs that may interfere with safe prescribing of controlled drugs.
Respuesta
  • True
  • False
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