CMN 577 UNIT 3 "Opioid Prescribing: Safe
Practice, Changing Lives"
What are benefits of Opiates? - CORRECT ANSWER-Analgesia
-Adequate pain control
-Continuous, predictable (with ER/LA opioids)
Improved function
Improved quality of life
What are risks of Opiates? - CORRECT ANSWER-Overdose
Life-threatening respiratory depression
Abuse by patient or household contacts
Misuse, diversion, and addiction
Physical dependence and tolerance Interactions with other medications and
substances
Risk of neonatal opioid withdrawal syndrome
Inadvertent exposure/ingestion by household contacts, especially children
What does REMS mean? - CORRECT ANSWER-Risk Evaluation and Mitigation
Strategy
What are the main goals of the REMS? - CORRECT ANSWER-help clinicians:
Understand how to assess patients for treatment with ER/LA opioids
Be familiar with how to initiate therapy, modify dosages, and discontinue use of
ER/LA opioids
Know how to manage ongoing therapy with ER/LA opioids
Know how to counsel patients and caregivers about the safe use of ER/LA
opioids, including proper storage and disposal
Be familiar with general and product-specific drug information concerning ER/LA
opioid
Domains of Pain to Assess: - CORRECT ANSWER--Location of pain
-Intensity of pain
-Quality of pain: eg, dull, stabbing, hot-burning, shooting, aching, piercing,
tingling, numb, radiating (use patient's words when possible)
, -Onset/duration of pain
-Variations/patterns/rhythms of pain: eg, the pain is constant, intermittent,
episodic/recurring
-What relieves the pain? eg, sitting, lying down, standing, heat, cold, rest,
distraction, exercise, movement
-What causes or increases the pain? eg, sitting, lying down, standing, heat, cold,
rest, exercise, movement
-What are the effects of pain? eg, sleep, movement, energy, lifestyle, personal
relationships, work, emotions, concentration, appetite, motivation, ADLs,
instrumental ADLs
-Patient's pain and functional goals: eg, comfortable sleep, comfort at rest,
comfort with movement, able to perform ADLs, QoL, acceptable level of pain
intensity on a 0-to-10 scale
-Current pain and function
What are some Physical Exam components to focus on when evaluating patient
with pain? - CORRECT ANSWER-General: vital signs, appearance, and pain
behaviors Neurologic examination
Musculoskeletal examination: inspection, gait and posture, range of motion,
palpation, percussion, auscultation, and provocative maneuvers
Cutaneous or trophic findings
What are features of the Opioid Risk Tool (ORT)? - CORRECT
ANSWER--Administered by patient
-Includes 5 items
-Assesses risk of aberrant drug-related behaviors
-May be better suited for primary care settings that have a predominantly low-risk
population
What are features of the Screener and Opioid Assessment for Patients with Pain
(SOAPP) - CORRECT ANSWER--Usually self-administered in waiting room or
examination room or before an office visit; may be completed as part of an
interview with a nurse, physician, or psychologist
-Includes 24, 14, and 5 items; 4 different formats available -Assesses risk of
aberrant drug-related behaviors
-May be particularly useful in high-risk settings
Practice, Changing Lives"
What are benefits of Opiates? - CORRECT ANSWER-Analgesia
-Adequate pain control
-Continuous, predictable (with ER/LA opioids)
Improved function
Improved quality of life
What are risks of Opiates? - CORRECT ANSWER-Overdose
Life-threatening respiratory depression
Abuse by patient or household contacts
Misuse, diversion, and addiction
Physical dependence and tolerance Interactions with other medications and
substances
Risk of neonatal opioid withdrawal syndrome
Inadvertent exposure/ingestion by household contacts, especially children
What does REMS mean? - CORRECT ANSWER-Risk Evaluation and Mitigation
Strategy
What are the main goals of the REMS? - CORRECT ANSWER-help clinicians:
Understand how to assess patients for treatment with ER/LA opioids
Be familiar with how to initiate therapy, modify dosages, and discontinue use of
ER/LA opioids
Know how to manage ongoing therapy with ER/LA opioids
Know how to counsel patients and caregivers about the safe use of ER/LA
opioids, including proper storage and disposal
Be familiar with general and product-specific drug information concerning ER/LA
opioid
Domains of Pain to Assess: - CORRECT ANSWER--Location of pain
-Intensity of pain
-Quality of pain: eg, dull, stabbing, hot-burning, shooting, aching, piercing,
tingling, numb, radiating (use patient's words when possible)
, -Onset/duration of pain
-Variations/patterns/rhythms of pain: eg, the pain is constant, intermittent,
episodic/recurring
-What relieves the pain? eg, sitting, lying down, standing, heat, cold, rest,
distraction, exercise, movement
-What causes or increases the pain? eg, sitting, lying down, standing, heat, cold,
rest, exercise, movement
-What are the effects of pain? eg, sleep, movement, energy, lifestyle, personal
relationships, work, emotions, concentration, appetite, motivation, ADLs,
instrumental ADLs
-Patient's pain and functional goals: eg, comfortable sleep, comfort at rest,
comfort with movement, able to perform ADLs, QoL, acceptable level of pain
intensity on a 0-to-10 scale
-Current pain and function
What are some Physical Exam components to focus on when evaluating patient
with pain? - CORRECT ANSWER-General: vital signs, appearance, and pain
behaviors Neurologic examination
Musculoskeletal examination: inspection, gait and posture, range of motion,
palpation, percussion, auscultation, and provocative maneuvers
Cutaneous or trophic findings
What are features of the Opioid Risk Tool (ORT)? - CORRECT
ANSWER--Administered by patient
-Includes 5 items
-Assesses risk of aberrant drug-related behaviors
-May be better suited for primary care settings that have a predominantly low-risk
population
What are features of the Screener and Opioid Assessment for Patients with Pain
(SOAPP) - CORRECT ANSWER--Usually self-administered in waiting room or
examination room or before an office visit; may be completed as part of an
interview with a nurse, physician, or psychologist
-Includes 24, 14, and 5 items; 4 different formats available -Assesses risk of
aberrant drug-related behaviors
-May be particularly useful in high-risk settings
