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NR546 Week 6 test your knowledge questions with correct answers
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NR546 Week 6 test your knowledge questionswith correct answers
Addiction |is |often |driven |by |the |client's |attempts |to: |- |correct |answer-self-medicate |an |
underlying |mental |health |disorder
adverse |effects |associated |with |the |acute |use |of |opioids: |- |correct |answer--Itching
-Constipation
-Respiratory |depression
-Urinary |retention
-Sedation
Opioid |medication: |Morphine |- |correct |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 |- |correct |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 |- |correct |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 |- |correct |answer--No |longer |recommended |as |an |analgesic, |
and |not |widely |available. |
-Has |numerous |concerning |adverse |effects |such |as |seizures |and |delirium.
Opioid |medication: |Methadone |- |correct |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 |- |correct |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 |- |correct |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 |- |correct |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 |- |correct |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.
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