NR546 Week 6 test your knowledge quiz with
correct answers
Addiction iis ioften idriven iby ithe iclient's iattempts ito: i- iANSWER: i i➡ iself-medicate ian iunderlying
imental ihealth idisorder
adverse ieffects iassociated iwith ithe iacute iuse iof iopioids: i- iANSWER: i i➡ i-Itching
-Constipation
-Respiratory idepression
-Urinary iretention
-Sedation
Opioid imedication: iMorphine i- iANSWER: i i➡ i-Prototype iopioid iagonist
-indicated ifor iacute ipain
-binds ito iopioid ireceptors iin ithe iCNS, iinhibiting iascending ipain ipathways, ialtering ithe
iperception i& iresponse ito ipain
-also iproduces iCNS idepression iand ipotentially irespiratory idepression
*may ibe ilife-threatening, iespecially iif iutilized iwith ibenzodiazepines, iCNS idepressants, ior
ialcohol
onset iof iaction:
-immediate irelease iformulation iis ipatient-dependent, iwith ivariable iabsorption. i
-IV iis i5-10 iminutes, iwith ia iduration i3-5 ihours. i
-Also iavailable iin icontrolled irelease iformulation i(MS iContin) iand iextended-release imorphine
i(Avinza).
Opioid imedication: iFentanyl i- iANSWER: i i➡ i-has ian ialmost iimmediate ionset iof iaction iwhen
igiven iIV, iwith ia iduration iof i0.5-1 ihour
-More ipotent ithan imorphine, ibut ishort iduration iof iaction
,-the ipreferred iopioid ifor ithose iunable ito itolerate imorphine ior ihydromorphone iand iin ithose iwith
isevere ihepatic iand irenal idisease
-same iindications ias imorphine iand iis ialso iused ifrequently iin iprocedural isedation iand igeneral
ianesthesia
-Conversion ibetween ifentanyl iproducts iis iNOT imcg ifor imcg
Opioid imedication: iHydromorphone i- iANSWER: i i➡ i-Similar iopioid iagonist ias imorphine ibut
imore ipotent
-Oral iand iparenteral idoses iare inot iequivalent i(parenteral idoses iup ito i5 itimes imore ipotent)
Opioid imedication: iMeperidine i- iANSWER: i i➡ i-No ilonger irecommended ias ian ianalgesic, iand
inot iwidely iavailable. i
-Has inumerous iconcerning iadverse ieffects isuch ias iseizures iand idelirium.
Opioid imedication: iMethadone i- iANSWER: i i➡ i-Utilized iin idetoxification iand imaintenance
itreatment iof iopioid iaddiction iand iheroin iaddiction, iwith ihigh ivariability iamong ipatients
-long iacting iopioid ithat ibinds ito iand ioccupies imu-opioid ireceptors, ireducing icraving ifor iopioids
iand iprevents iwithdrawal isymptoms ifor i24 ihours
-potential ifor iabuse, ionly ilicensed iopioid itreatment iprograms ior ilicensed iinpatient ihospital
iunits ipermitted ito iorder iand idispense ithis imedication
-potential ifor ilife ithreatening irespiratory idepression iand iQT iprolongation
-Equianalgesic iconversion iratios ibetween imethadone iand iother iopioids iare iindividually
ivariable, iwith ideaths ioccurring iduring iconversion ifrom ichronic ihigh idose iopiate ihistory ior
iopioid iabuse ito imethadone
-Discontinuation irequires ia iwean ito iavoid iwithdrawal
-pregnant, ia irisk ibenefit iratio iis inecessary ias ifetal ioutcomes iare iimproved ias icompared ito
iillicit idrug iuse, ihowever ican ihave idecreased ibirth iweight, ilength, ihead icircumference iand ifetal
igrowth
Opioid imedication: iKetamine i- iANSWER: i i➡ i-Medication iuseful iin igeneral ianesthesia iand
iprocedural isedation
-off ilabel iusage ias iinfusions ifor iacute ipain, ias iboth ia istand-alone itreatment, ias ian iadjunctive
ioption iwith iopioids, ias iwell ias ian iintranasal iformulation.
, Opioid imedication: iTramadol i- iANSWER: i i➡ i-Opioid iagonist, iwith isimilar iindications iand iside
ieffect iprofile ias iother iopioids, ibut ithat ialso iblocks ireuptake iof iserotonin iand inorepinephrine.
-Indicated ifor iacute ipain imanagement, iwith iadded ibenefit ifor ipatients iwith ineuropathic ipain iand
inociceptive ipain. i
-Has ia ilower irisk iof iconstipation iand idependence ithan iother iopioids, ibut idoes ihave irisk iof
iserotonin isyndrome.
Opioid imedication: iNaloxone i- iANSWER: i i➡ i-pure iantagonist, iwith iclinical iindication ifor
itreatment iof iacute iopioid ioverdose. i
-IV inaloxone ican idramatically ireverse iopioids, ieven iin icomatose istates
-recent iwidespread icommunity iavailability iof iintramuscular iand iintranasal iadministration
ioptions iavailable igiven ithe iprescription iand irecreational iopiate icrisis, iand irelated ideaths. i-
Given ithe ishort iduration iof iaction, ipatients ican irelapse iinto icoma ior iprevious ioverdose istate,
iand imay ineed icontinued imonitoring iand ipotentially ifurther idoses ior iconstant iinfusion.
Opioid imedication: iClonidine i- iANSWER: i i➡ i-antihypertensive iagent, iand iAlpha2-Adrenergic
iAgonist
-off-label iadjunctive itreatment ifor imedically isupervised iopioid iwithdrawal. i
-Initial itreatment iis i0.1mg-0.2mg, iwith iability ito irepeat iup ito i4 idoses iuntil isymptoms iresolve,
iwhile iassuring istability iof iblood ipressure iand iheart irate. i
-Maintenance iwould ibe idetermined iby iseverity iof isymptoms, iwith itreatment ievery i6-8 ihours. i
-Thought ito iproduce ianalgesia iat ipresynaptic iand ipost ijunction ialpha-2 iadrenoceptors iin ithe
ispinal icord, iwith ipain itransmission ito ithe ibrain iprevented.
Substance iuse idisorder ioccurs iwhen: i- iANSWER: i i➡ iThe irecurrent iuse iof ia isubstance, isuch ias
ialcohol ior idrugs, icauses iclinically isignificant iimpairment, iincluding ihealth iproblems, idisability,
ior ifailure ito imeet iresponsibilities iat ihome, iwork, ior ischool.
Dual iDiagnosis iand iSubstance iUse iDisorders i- iANSWER: i i➡ iDual idiagnoses iare icommon iin
iaddiction imedicine
-up ito i60% iof iadolescents iin icommunity-based isubstance iuse idisorder itreatment iprograms
imay imeet ithe idiagnostic icriteria ifor ianother imental ihealth icondition
-Clients imay iself-medicate ito itreat idistressing isymptoms iof iother iconditions
correct answers
Addiction iis ioften idriven iby ithe iclient's iattempts ito: i- iANSWER: i i➡ iself-medicate ian iunderlying
imental ihealth idisorder
adverse ieffects iassociated iwith ithe iacute iuse iof iopioids: i- iANSWER: i i➡ i-Itching
-Constipation
-Respiratory idepression
-Urinary iretention
-Sedation
Opioid imedication: iMorphine i- iANSWER: i i➡ i-Prototype iopioid iagonist
-indicated ifor iacute ipain
-binds ito iopioid ireceptors iin ithe iCNS, iinhibiting iascending ipain ipathways, ialtering ithe
iperception i& iresponse ito ipain
-also iproduces iCNS idepression iand ipotentially irespiratory idepression
*may ibe ilife-threatening, iespecially iif iutilized iwith ibenzodiazepines, iCNS idepressants, ior
ialcohol
onset iof iaction:
-immediate irelease iformulation iis ipatient-dependent, iwith ivariable iabsorption. i
-IV iis i5-10 iminutes, iwith ia iduration i3-5 ihours. i
-Also iavailable iin icontrolled irelease iformulation i(MS iContin) iand iextended-release imorphine
i(Avinza).
Opioid imedication: iFentanyl i- iANSWER: i i➡ i-has ian ialmost iimmediate ionset iof iaction iwhen
igiven iIV, iwith ia iduration iof i0.5-1 ihour
-More ipotent ithan imorphine, ibut ishort iduration iof iaction
,-the ipreferred iopioid ifor ithose iunable ito itolerate imorphine ior ihydromorphone iand iin ithose iwith
isevere ihepatic iand irenal idisease
-same iindications ias imorphine iand iis ialso iused ifrequently iin iprocedural isedation iand igeneral
ianesthesia
-Conversion ibetween ifentanyl iproducts iis iNOT imcg ifor imcg
Opioid imedication: iHydromorphone i- iANSWER: i i➡ i-Similar iopioid iagonist ias imorphine ibut
imore ipotent
-Oral iand iparenteral idoses iare inot iequivalent i(parenteral idoses iup ito i5 itimes imore ipotent)
Opioid imedication: iMeperidine i- iANSWER: i i➡ i-No ilonger irecommended ias ian ianalgesic, iand
inot iwidely iavailable. i
-Has inumerous iconcerning iadverse ieffects isuch ias iseizures iand idelirium.
Opioid imedication: iMethadone i- iANSWER: i i➡ i-Utilized iin idetoxification iand imaintenance
itreatment iof iopioid iaddiction iand iheroin iaddiction, iwith ihigh ivariability iamong ipatients
-long iacting iopioid ithat ibinds ito iand ioccupies imu-opioid ireceptors, ireducing icraving ifor iopioids
iand iprevents iwithdrawal isymptoms ifor i24 ihours
-potential ifor iabuse, ionly ilicensed iopioid itreatment iprograms ior ilicensed iinpatient ihospital
iunits ipermitted ito iorder iand idispense ithis imedication
-potential ifor ilife ithreatening irespiratory idepression iand iQT iprolongation
-Equianalgesic iconversion iratios ibetween imethadone iand iother iopioids iare iindividually
ivariable, iwith ideaths ioccurring iduring iconversion ifrom ichronic ihigh idose iopiate ihistory ior
iopioid iabuse ito imethadone
-Discontinuation irequires ia iwean ito iavoid iwithdrawal
-pregnant, ia irisk ibenefit iratio iis inecessary ias ifetal ioutcomes iare iimproved ias icompared ito
iillicit idrug iuse, ihowever ican ihave idecreased ibirth iweight, ilength, ihead icircumference iand ifetal
igrowth
Opioid imedication: iKetamine i- iANSWER: i i➡ i-Medication iuseful iin igeneral ianesthesia iand
iprocedural isedation
-off ilabel iusage ias iinfusions ifor iacute ipain, ias iboth ia istand-alone itreatment, ias ian iadjunctive
ioption iwith iopioids, ias iwell ias ian iintranasal iformulation.
, Opioid imedication: iTramadol i- iANSWER: i i➡ i-Opioid iagonist, iwith isimilar iindications iand iside
ieffect iprofile ias iother iopioids, ibut ithat ialso iblocks ireuptake iof iserotonin iand inorepinephrine.
-Indicated ifor iacute ipain imanagement, iwith iadded ibenefit ifor ipatients iwith ineuropathic ipain iand
inociceptive ipain. i
-Has ia ilower irisk iof iconstipation iand idependence ithan iother iopioids, ibut idoes ihave irisk iof
iserotonin isyndrome.
Opioid imedication: iNaloxone i- iANSWER: i i➡ i-pure iantagonist, iwith iclinical iindication ifor
itreatment iof iacute iopioid ioverdose. i
-IV inaloxone ican idramatically ireverse iopioids, ieven iin icomatose istates
-recent iwidespread icommunity iavailability iof iintramuscular iand iintranasal iadministration
ioptions iavailable igiven ithe iprescription iand irecreational iopiate icrisis, iand irelated ideaths. i-
Given ithe ishort iduration iof iaction, ipatients ican irelapse iinto icoma ior iprevious ioverdose istate,
iand imay ineed icontinued imonitoring iand ipotentially ifurther idoses ior iconstant iinfusion.
Opioid imedication: iClonidine i- iANSWER: i i➡ i-antihypertensive iagent, iand iAlpha2-Adrenergic
iAgonist
-off-label iadjunctive itreatment ifor imedically isupervised iopioid iwithdrawal. i
-Initial itreatment iis i0.1mg-0.2mg, iwith iability ito irepeat iup ito i4 idoses iuntil isymptoms iresolve,
iwhile iassuring istability iof iblood ipressure iand iheart irate. i
-Maintenance iwould ibe idetermined iby iseverity iof isymptoms, iwith itreatment ievery i6-8 ihours. i
-Thought ito iproduce ianalgesia iat ipresynaptic iand ipost ijunction ialpha-2 iadrenoceptors iin ithe
ispinal icord, iwith ipain itransmission ito ithe ibrain iprevented.
Substance iuse idisorder ioccurs iwhen: i- iANSWER: i i➡ iThe irecurrent iuse iof ia isubstance, isuch ias
ialcohol ior idrugs, icauses iclinically isignificant iimpairment, iincluding ihealth iproblems, idisability,
ior ifailure ito imeet iresponsibilities iat ihome, iwork, ior ischool.
Dual iDiagnosis iand iSubstance iUse iDisorders i- iANSWER: i i➡ iDual idiagnoses iare icommon iin
iaddiction imedicine
-up ito i60% iof iadolescents iin icommunity-based isubstance iuse idisorder itreatment iprograms
imay imeet ithe idiagnostic icriteria ifor ianother imental ihealth icondition
-Clients imay iself-medicate ito itreat idistressing isymptoms iof iother iconditions
