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NR546 Week 6 test your knowledge quiz with correct answers .
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- Healthcare Finance MHA 706
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- Healthcare Finance MHA 706
NR546 Week 6 test your knowledge quiz with correct answers .
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NR546 Week 6 test your knowledge quizwith correct answers
Addiction is often driven by the client's attempts to: - ANSWER-self-medicate an
underlying mental health disorder
adverse effects associated with the acute use of opioids: - ANSWER--Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation
Opioid medication: Morphine - ANSWER--Prototype opioid agonist
-indicated for acute pain
-binds to opioid receptors in the CNS, inhibiting ascending pain pathways,
altering the perception & response to pain
-also produces CNS depression and potentially respiratory depression
*may be life-threatening, especially if utilized with benzodiazepines, CNS
depressants, or alcohol
onset of action:
-immediate release formulation is patient-dependent, with variable absorption.
-IV is 5-10 minutes, with a duration 3-5 hours.
-Also available in controlled release formulation (MS Contin) and
extended-release morphine (Avinza).
Opioid medication: Fentanyl - ANSWER--has an almost immediate onset of
action when given IV, with a duration of 0.5-1 hour
-More potent than morphine, but short duration of action
-the preferred opioid for those unable to tolerate morphine or hydromorphone
and in those with severe hepatic and renal disease
-same indications as morphine and is also used frequently in procedural sedation
and general anesthesia
,-Conversion between fentanyl products is NOT mcg for mcg
Opioid medication: Hydromorphone - ANSWER--Similar opioid agonist as
morphine but more potent
-Oral and parenteral doses are not equivalent (parenteral doses up to 5 times
more potent)
Opioid medication: Meperidine - ANSWER--No longer recommended as an
analgesic, and not widely available.
-Has numerous concerning adverse effects such as seizures and delirium.
Opioid medication: Methadone - ANSWER--Utilized in detoxification and
maintenance treatment of opioid addiction and heroin addiction, with high
variability among patients
-long acting opioid that binds to and occupies mu-opioid receptors, reducing
craving for opioids and prevents withdrawal symptoms for 24 hours
-potential for abuse, only licensed opioid treatment programs or licensed
inpatient hospital units permitted to order and dispense this medication
-potential for life threatening respiratory depression and QT prolongation
-Equianalgesic conversion ratios between methadone and other opioids are
individually variable, with deaths occurring during conversion from chronic high
dose opiate history or opioid abuse to methadone
-Discontinuation requires a wean to avoid withdrawal
-pregnant, a risk benefit ratio is necessary as fetal outcomes are improved as
compared to illicit drug use, however can have decreased birth weight, length,
head circumference and fetal growth
Opioid medication: Ketamine - ANSWER--Medication useful in general
anesthesia and procedural sedation
-off label usage as infusions for acute pain, as both a stand-alone treatment, as
an adjunctive option with opioids, as well as an intranasal formulation.
Opioid medication: Tramadol - ANSWER--Opioid agonist, with similar indications
and side effect profile as other opioids, but that also blocks reuptake of serotonin
and norepinephrine.
-Indicated for acute pain management, with added benefit for patients with
neuropathic pain and nociceptive pain.
, -Has a lower risk of constipation and dependence than other opioids, but does
have risk of serotonin syndrome.
Opioid medication: Naloxone - ANSWER--pure antagonist, with clinical indication
for treatment of acute opioid overdose.
-IV naloxone can dramatically reverse opioids, even in comatose states
-recent widespread community availability of intramuscular and intranasal
administration options available given the prescription and recreational opiate
crisis, and related deaths. -Given the short duration of action, patients can
relapse into coma or previous overdose state, and may need continued
monitoring and potentially further doses or constant infusion.
Opioid medication: Clonidine - ANSWER--antihypertensive agent, and
Alpha2-Adrenergic Agonist
-off-label adjunctive treatment for medically supervised opioid withdrawal.
-Initial treatment is 0.1mg-0.2mg, with ability to repeat up to 4 doses until
symptoms resolve, while assuring stability of blood pressure and heart rate.
-Maintenance would be determined by severity of symptoms, with treatment
every 6-8 hours.
-Thought to produce analgesia at presynaptic and post junction alpha-2
adrenoceptors in the spinal cord, with pain transmission to the brain prevented.
Substance use disorder occurs when: - ANSWER-The recurrent use of a
substance, such as alcohol or drugs, causes clinically significant impairment,
including health problems, disability, or failure to meet responsibilities at home,
work, or school.
Dual Diagnosis and Substance Use Disorders - ANSWER-Dual diagnoses are
common in addiction medicine
-up to 60% of adolescents in community-based substance use disorder treatment
programs may meet the diagnostic criteria for another mental health condition
-Clients may self-medicate to treat distressing symptoms of other conditions
-Common comorbidities include:
• anxiety disorders
• depression
• bipolar disorder
• psychotic illness
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