Deck 9: Medicines Used to Relieve Pain and Produce Anaesthesia

Question 1

The opioid tramadol should be avoided in clients with:

A) epilepsy.
B) a heart condition.
C) asthma.
D) liver disease.

Answer 1

epilepsy.

Question 2

Which of the following is not a characteristic of oxycodone?

A) It has less of a hepatic first pass than morphine.
B) It has a shorter half-life than morphine.
C) It comes as a suppository formulation, which is useful for overnight analgesia.
D) It comes as a scored tablet formulation, which can be crushed and given with water to clients who have difficulties in swallowing tablets whole.

Answer 2

It has a shorter half-life than morphine.

Question 3

When administering tramadol, it should not be given with drugs that:

A) affect coagulation.
B) affect blood vessel vasculature.
C) are largely metabolised renally.
D) increase seizure tendencies.

Answer 3

increase seizure tendencies.

Question 4

The opioid receptors most involved in mediating analgesia are:

A) delta and epsilon.
B) kappa and delta.
C) mu and epsilon.
D) mu and kappa.

Question 5

The mechanism of action of the local anaesthetics is to impede the movement of which ion through its membrane channels?

A) Calcium.
B) Potassium.
C) Sodium.
D) GABA.

Question 6

Controlled-release preparations of ketoprofen should be taken ________ to improve the symptoms of arthritic pain.

A) immediately after meals
B) 15 minutes before physical activity
C) at bedtime
D) upon rising in the morning

Question 7

Analgesic agents that are effective in treating mild to moderate acute migraine headaches include:

A) ibuprofen and indomethacin.
B) aspirin and paracetamol.
C) piroxicam and sulindac.
D) propranolol and ketamine.

Question 8

Which of the following is not a contraindication for the use of nitrous oxide as an inhalational anaesthetic?

A) Pneumothorax.
B) Surgical procedures involving the middle ear.
C) Tachycardia.
D) Intestinal obstruction.

Question 9

Which substance enhances the absorption of ergotamine?

A) Apple juice.
B) Sumatriptan.
C) Dairy products.
D) Caffeine.

Question 10

Which of the following local anaesthetics has a relatively long duration of action?

A) Procaine.
B) Lignocaine.
C) Bupivacaine.
D) Mepivacaine.

Question 11

The propionic acid derivatives ibuprofen and naproxen are useful for children suffering from inflammatory disease because:

A) they are not metabolised in the liver.
B) they do not cause gastrointestinal problems.
C) they are available as oral liquids so that the exact dose can be administered.
D) they do not affect platelet aggregation.

Question 12

Which of the following narcotics has a prolonged duration of action?

A) Pethidine.
B) Methadone.
C) Codeine.
D) Fentanyl.

Question 13

Which enzyme is the target for inhibition by the NSAIDs?

A) Cyclo-oxygenase.
B) Phospholipase A.
C) Adenylate cyclase.
D) 5-Lipoxygenase.

Question 14

Somatic pain is defined as:

A) pain of sudden onset and short duration.
B) pain associated with the musculoskeletal system.
C) a reaction that avoids further tissue damage.
D) pain induced through remodelling of neural connections.

Question 15

Aspirin needs to be stopped approximately ________ before planned surgery and some complex dental procedures because of the possibility of increased bleeding.

A) two days
B) seven days
C) two weeks
D) seven weeks

Question 16

Extreme diligence should be exercised in administering the correct dose of paracetamol to children because overdose can lead to:

A) gastrointestinal bleeding.
B) renal failure.
C) inhibition of the hypothalamic control on temperature.
D) liver damage.

Question 17

Which of the following routes of administration has the highest rate of systemic absorption of local anaesthetic agents?

A) Epidural administration.
B) Intercostal administration.
C) Subcutaneous administration.
D) Brachial plexus administration.

Question 18

How does metoclopramide assist in the treatment of an acute migraine?

A) It decreases the incidence of nausea and vomiting.
B) It increases the absorption of ergotamine.
C) It decreases the rate at which ergotamine is excreted.
D) It inhibits the isoenzyme of the cytochrome P450 system that metabolises ergotamine.

Question 19

What is the equivalent dose of pethidine when compared with 10 mg of morphine?

A) 25-50 mg of pethidine.
B) 50-75 mg of pethidine.
C) 75-100 mg of pethidine.
D) 100-125 mg of pethidine.

Question 20

The combined use of salicylates and corticosteroids may lead to ________ and should therefore be avoided.

A) tinnitus
B) renal failure
C) peptic ulceration
D) liver failure

Question 21

Which of the following pain medicines produce a constipating effect?

A) Pethidine.
B) Aspirin.
C) Morphine.
D) Paracetamol.

Question 22

Intrathecal administration of anaesthetic produces:

A) profound anaesthesia with a small dose.
B) a mild analgesic effect with a small dose.
C) analgesia via the nerve roots that communicate with the epidural space.
D) no analgesic effect, this route of administration is inappropriate to achieve analgesia.

Question 23

The rate of absorption of inhaled anaesthetic into the bloodstream is dependent on the ________ of the gas.

A) rate of osmosis
B) partial pressure
C) volume
D) surfactant levels

Question 24

Which of the following is true of ergotamine for migraine prophylaxis?

A) Caffeine enhances its absorption and onset of action.
B) No more than five doses should be taken in any one week.
C) Doses should be closely monitored due to the risk of rebound headaches and dependence.
D) All of the above.

Question 25

First line therapy for an acute migraine attack includes:

A) triptans.
B) paracetamol.
C) ergotamine.
D) tricyclic antidepressants.

Question 26

Which micronutrient should be supplemented with methotrexate use?

A) Folate.
B) Thiamin.
C) Riboflavin.
D) Pyridoxine.

Question 27

Preventative therapies for migraine should be used for a period of:

A) three to six days.
B) three to six weeks.
C) three to six months.
D) six to twelve months.

Question 28

In treating an acute migraine attack, sumatriptan should not be given with ergotamine because:

A) the combination may lead to excessive bronchoconstriction.
B) the combination may lead to excessive vasoconstriction.
C) the combination may lead to gastrointestinal bleeding.
D) the combination may lead to excessive diuresis.

Question 29

NSAIDs may not be suitable for use in individuals with renal impairment because:

A) they increase sodium excretion.
B) they increase body temperature.
C) they reduce glomerular filtration rate.
D) they reduce pepsin levels in the stomach.

Question 30

The reason that methadone is used to help wean people off heroin is that:

A) methadone has a longer half-life, which contributes to weaker withdrawal symptoms.
B) methadone is administered orally, reducing syringe use.
C) methadone binds to opioid receptors leaving few receptors available for a heroin 'high'.
D) all of the above.