Deck 13: Drugs for the Control of Pain and Fever

Question 1

The following substance is important for controlling whether pain signals continue to the brain.

A) Serotonin
B) Substance P
C) Norepinephrine
D) Prostaglandins

Answer 1

Substance P

Question 2

Which statements are true regarding pain medications? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Opioids act within the CNS.
B) NSAIDs act at the peripheral level.
C) NSAIDs act within the CNS.
D) Opioids act at the peripheral level.
E) Narcotics act within the CNS.

Answer 2

Opioids act within the CNS.
NSAIDs act at the peripheral level.
Narcotics act within the CNS.

Question 3

Pure opioids such as morphine activate these receptors in order to lessen pain. (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Delta
B) Dopamine
C) Mu
D) Kappa

Answer 3

Mu
Kappa

Question 4

The pharmacy technician instructs a patient on non-pharmacologic therapies for pain management. Which techniques should be included in this teaching? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Reiki
B) Heat or cold packs
C) Massage
D) Anti-inflammatory drugs
E) Opioid drugs

Question 5

Alternatives or adjuncts to pharmacological therapies for pain would include: (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Acupuncture
B) Ibuprofen
C) Chiropractic manipulation
D) Acetaminophen

Question 6

The pharmacist is caring for a patient who has a morphine PCA. Which medication should the pharmacist ensure is readily available?

A) Meperidine
B) Naloxone hydrochloride
C) Butorphanol tartrate
D) Naltrexone hydrochloride

Question 7

Naloxone would work by blocking this opioid receptor: (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Delta
B) Mu
C) Kappa
D) Serotonin

Question 8

This product is typically given to help reduce the dependence on opioids and reduce the withdrawal effects.

A) Acetaminophen
B) Naloxone
C) Methadone
D) Heroin

Question 9

The release of this chemical, which reacts with the nociceptors, will cause the message of pain to start at the site of injury.

A) Substance P
B) Serotonin
C) Prostaglandins
D) Histamine

Question 10

The pharmacist is caring for a patient who is experiencing mild inflammation. Which treatment options does the pharmacist anticipate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Ice packs
B) Rest
C) Glucocorticoids
D) NSAIDs
E) Insulin

Question 11

The pharmacist is caring for an adult patient with a fever. Which medications are appropriate for the patient to take? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Aceteminophen
B) Ibuprofen
C) Aspirin
D) Prednisolone
E) Methylprednisolone

Question 12

A patient is being discharged with a prescription for oxycodone HCl. Which discharge instructions are appropriate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A) Increase the dose of oxycodone if the pain returns.
B) Maintain adequate fluid intake.
C) Withhold the medication if respirations are fewer than 12 breaths per minute.
D) Use OTC sleep-inducing antihistamines when needed.
E) Use OTC medications for constipation, if needed

Question 13

The pharmacist is instructing a patient on the proper procedure for taking an extended-release tablet. Which statement by the patient indicates understanding of the instructions?

A) "Because these are extended-release tablets, it is okay to chew them."
B) "Because these are extended-release tablets, it is okay to crush them."
C) "Because these are extended-release tablets, it is okay to break them in half."
D) "Because these are extended-release tablets, I must swallow them whole."

Question 14

All patients perceive pain to the same degree.

Question 15

Spinal substance P is critical because it controls whether pain signals will continue to the brain.

Question 16

Pure opioids would bind to the mu and kappa receptors to produce a strong pain killing effect.

Question 17

When used together with medication, non-pharmacological techniques often allow for lowering of medication doses.

Question 18

Opioids interact with at least six types of receptors: mu (types one and two), kappa, sigma,
delta, and epsilon but from the perspective of pain management, the mu and delta receptors are the most important.

Question 19

Butorphanol is an example of a pure opioid antagonist used to reverse the effects of opioid overdose.

Question 20

One method of treating opioid dependence has been to switch the patient from intravenous
and inhalation forms of illegal drugs to injectable methadone.

Question 21

Typical signs and symptoms of inflammation is dehydration and paleness of skin.

Question 22

The chemical mediators of inflammation are released from the mast cell when it ruptures as part of the inflammatory response.

Question 23

An NSAID, such as acetaminophen, would prevent the inflammatory response by preventing the formation of prostaglandins.

Question 24

A fever results when the pituitary becomes reset to maintain the body at a new temperature that is higher than the normal temperature of 37°C.

Question 25

Typical classes of drugs to prevent migraines are triptans, beta-adrenergic blockers, calcium channel blockers, antidepressants, and antiseizure drugs.

Question 26

An example of an analgesic commonly used to treat nervopathic pain would be pregabalin.

Question 27

Acetaminophen is a common and safe drug used to treat inflammation.

Question 28

Mr. Jones has been taking part in the methadone maintenance program for several years and now can bring his weekend doses home with him. During the evening, his 3 year old daughter accidently ingests half of his methadone dose that was left behind in a glass. What may be the repercussions? What could have been done to avoid this from happening?

Question 29

A patient is on fentanyl patches for your chronic pain. The patient gives old patches to a friend to discard. The next day, the friend is found dead after smoking the fentanyl patch. Why did this result in death? How could this have been prevented?

Question 30

Ms. Coidiuf, age 42, sustained a back injury three years ago, which responded well to treatment with nonsteroidal anti-inflammatory medication. Over the last six months, Ms. Coidiuf has been seeing her physician again with complaints of painful sensations "shooting" down her right hip. Despite careful attention, it appears that Ms. Coidiuf's pain is no longer responding to anti-inflammatory medication. Her physician prescribes a narcotic analgesic (moderate effectiveness) with acetaminophen, hoping this treatment might provide relief. Following three physical therapy sessions, the patient continues to report that she is "still miserable," leading her physician to believe that her condition is worsening. Heat packs, massage, and relaxation therapy have not been successful.
-What was the most likely target of pharmacological intervention for Ms. Coidiuf three years ago?

Question 31

Ms. Coidiuf, age 42, sustained a back injury three years ago, which responded well to treatment with nonsteroidal anti-inflammatory medication. Over the last six months, Ms. Coidiuf has been seeing her physician again with complaints of painful sensations "shooting" down her right hip. Despite careful attention, it appears that Ms. Coidiuf's pain is no longer responding to anti-inflammatory medication. Her physician prescribes a narcotic analgesic (moderate effectiveness) with acetaminophen, hoping this treatment might provide relief. Following three physical therapy sessions, the patient continues to report that she is "still miserable," leading her physician to believe that her condition is worsening. Heat packs, massage, and relaxation therapy have not been successful.

-Which narcotic analgesics was probably given to Ms. Coidiuf?

Question 32

Ms. Coidiuf, age 42, sustained a back injury three years ago, which responded well to treatment with nonsteroidal anti-inflammatory medication. Over the last six months, Ms. Coidiuf has been seeing her physician again with complaints of painful sensations "shooting" down her right hip. Despite careful attention, it appears that Ms. Coidiuf's pain is no longer responding to anti-inflammatory medication. Her physician prescribes a narcotic analgesic (moderate effectiveness) with acetaminophen, hoping this treatment might provide relief. Following three physical therapy sessions, the patient continues to report that she is "still miserable," leading her physician to believe that her condition is worsening. Heat packs, massage, and relaxation therapy have not been successful.

-Which symptom has Ms. Coidiuf likely avoided by her physician switching to narcotic therapy?