PHCY 631 – Pain Questions with correct answers
Nociceptive vs neuropathic pain Correct Answer-Nociceptive pain is
caused by damage to body tissue and usually described as a sharp,
aching, or throbbing pain
Neuropathic pain occurs when there is nerve damage. Often described as
lightening-like, shocking, or burning
Pain process (4 steps) Correct Answer-transduction (stimulation of
nociceptors), transmission (signal sent to CNS), modulation (CNS
attenuates or amplifies pain signaling), and perception (cognitive and
behavior response to pain)
Acute vs chronic pain Correct Answer-Acute: <30 days
Chronic: >3 months
What are the major etiologies of pain in cancer? Correct Answer-1. pain
caused by disease itself (tumor invasion, organ obstruction)
2. pain related to treatment (anticancer drugs, radiation, surgical
incisions)
3. pain resulting from diagnosing procedures (biopsy)
What is something you need to consider when converting between
opioids? Correct Answer-Cross-tolerance. When converting, reduce
dose by 25-50% to accomodate
Which opioids undergo glucuronidation? Are they converted to active or
inactive metabolite? Correct Answer-Morphine (converted to inactive &
active products)
Hydromorphone (converted to active)
Oxymorphone (converted to inactive)
Levophanol (converted to inactive)
Codeine
Tapentadol (converted to inactive)
Major DDI/PK consideration for codeine? Correct Answer-CYP2D6 ->
converts to active metabolite. Ultrarapid metabolizers will have
exaggerated response. Poor metabolizers will not respond to treatment
and have continued pain.
How to use the opioid conversion chart given the following:
Converting 20 mg IV morphine to PO oxycodone.
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