Drug Scheduling and Refill Requirements
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Questions and Answers

Which of the following medications is classified as a Schedule IV drug with a low potential for abuse?

  • Robitussin AC
  • Xanax (correct)
  • Anabolic steroids
  • Ketamine

    • What defines acute pain according to the CDC classifications?

  • Constant pain without interruption
  • Duration of less than 1 month (correct)
  • Duration of more than 3 months
  • Duration of 1-3 months

    • Which type of pain is characterized as neuropathic pain?

  • Visceral pain such as appendicitis
  • Nerve pain associated with diabetes (correct)
  • Chronic recurrent headaches
  • Skin and mucosal ulceration

    • Which Schedule V drug is commonly an antidiarrheal medication?

    <p>Lomotil</p> Signup and view all the answers

    What is the maximum number of refills allowed for a Schedule IV drug?

    <p>Up to 5 refills</p> Signup and view all the answers

    Which of the following is a symptom of mixed or undetermined etiology pain?

    <p>Chronic recurring headaches</p> Signup and view all the answers

    What distinguishes chronic pain from subacute pain?

    <p>Chronic pain lasts more than 3 months.</p> Signup and view all the answers

    What is a common misconception regarding infants and pain treatment?

    <p>Infants do not experience pain.</p> Signup and view all the answers

    Which is a significant factor contributing to the undertreatment of pain in pediatric patients?

    <p>Concerns about adverse effects of treatments.</p> Signup and view all the answers

    What is recommended as the first-line treatment for pain management during pregnancy?

    <p>Non-pharmacological treatments.</p> Signup and view all the answers

    What should be considered when treating elderly patients with pain?

    <p>Cognitive impairments may affect pain assessment.</p> Signup and view all the answers

    What potential risk is associated with opioid use during pregnancy?

    <p>Higher rates of neural tube defects.</p> Signup and view all the answers

    Which of the following is a concern when prescribing opioids for personal use or for family members?

    <p>Full evaluation is required before prescribing.</p> Signup and view all the answers

    What physiological change in elderly patients can affect drug metabolism?

    <p>Decreased liver function.</p> Signup and view all the answers

    What disadvantage can arise from a lack of reassessment strategies for pain in pediatric patients?

    <p>It may lead to prolonged suffering due to unaddressed pain.</p> Signup and view all the answers

    What is one of the reasons pain can worsen for children and their parents?

    <p>Pain is multifaceted and can create feelings of lack of control.</p> Signup and view all the answers

    Which of the following medication is considered a first-line treatment for fibromyalgia?

    <p>Duloxetine</p> Signup and view all the answers

    What is one of the new recommended approaches by the CDC for prescribing opioids?

    <p>Consider non-opioid therapies before opioids</p> Signup and view all the answers

    Which receptor activation is primarily associated with analgesia and euphoria?

    <p>Mu receptors</p> Signup and view all the answers

    What distinguishes an antagonist from an agonist?

    <p>An antagonist blocks the receptor while an agonist stimulates it</p> Signup and view all the answers

    What does 'affinity' refer to when discussing receptors?

    <p>The strength of the connection with the receptor site</p> Signup and view all the answers

    What is a significant concern associated with the use of acetylsalicylic acid (ASA) in children?

    <p>Possible development of Reye’s Syndrome</p> Signup and view all the answers

    Which population is advised against the use of NSAIDs due to the risk of gastrointestinal bleeding?

    <p>Individuals aged over 65 years</p> Signup and view all the answers

    Which formulation of NSAIDs is associated with lower serum concentrations but still presents GI bleeding concerns?

    <p>Topical NSAIDs</p> Signup and view all the answers

    What is a major risk associated with the concurrent use of ASA and NSAIDs?

    <p>Reduced effectiveness of ASA</p> Signup and view all the answers

    What is the maximum recommended daily dosage of acetaminophen for a typical adult?

    <p>4,000 mg</p> Signup and view all the answers

    Which of the following medications is known to have a potential risk for gastrointestinal bleeding when used at higher doses?

    <p>Ibuprofen</p> Signup and view all the answers

    What should be avoided alongside acetaminophen to prevent increased liver toxicity?

    <p>Alcohol consumption</p> Signup and view all the answers

    What physiological effect does blocking Cox-2 have on patients?

    <p>Elevated risk of cardiovascular events</p> Signup and view all the answers

    Which of the following statements correctly describes the difference between Cox-1 and Cox-2 enzymes?

    <p>Cox-1 is always present in the body; Cox-2 is produced during tissue injury.</p> Signup and view all the answers

    Which of the following is a concern with combination products containing acetaminophen?

    <p>Potential unintentional overdose</p> Signup and view all the answers

    What potential consequence is associated with consuming alcohol while taking acetaminophen?

    <p>Risk of liver damage</p> Signup and view all the answers

    What is an essential teaching point regarding the application of capsaicin cream?

    <p>Avoid contact with eyes and mucous membranes</p> Signup and view all the answers

    Which class of medications is most commonly prescribed for treating fibromyalgia?

    <p>Anticonvulsants</p> Signup and view all the answers

    For which condition is medical marijuana NOT typically FDA approved?

    <p>Severe allergies</p> Signup and view all the answers

    What is the primary difference between acute/abortive and prophylactic treatments for migraines?

    <p>Acute treatments are administered at the onset of a headache</p> Signup and view all the answers

    What is a common side effect of the local anesthetic lidocaine?

    <p>Vasovagal response</p> Signup and view all the answers

    Which medication is an example of an ergot alkaloid used for migraine treatment?

    <p>Dihydroergotamine</p> Signup and view all the answers

    Which of the following is a characteristic of TCAs used in pain management?

    <p>They may be effective for trigeminal neuralgia</p> Signup and view all the answers

    Which of the following statements about cannabinoid medications is FALSE?

    <p>Cannabinoids have no use in psychotherapy</p> Signup and view all the answers

    What is a potential risk when combining multiple products that contain acetaminophen?

    <p>Increased risk of overdose</p> Signup and view all the answers

    What is the primary reason for drugs to be scheduled under controlled substances?

    <p>Potential for use, misuse, and addiction</p> Signup and view all the answers

    Which schedule includes drugs with the highest potential for abuse and no accepted medical use?

    <p>Schedule I</p> Signup and view all the answers

    How must a prescription for Schedule II drugs be handled in emergencies?

    <p>Phoned in followed by a written prescription</p> Signup and view all the answers

    What type of dependence is associated with Schedule II drugs?

    <p>Severe psychological or physical dependence</p> Signup and view all the answers

    What is the maximum number of refills allowed for a prescription of Schedule III drugs?

    <p>5 refills</p> Signup and view all the answers

    Which of the following drugs is an example of a Schedule II controlled substance?

    <p>Hydrocodone combination products</p> Signup and view all the answers

    What is required for a prescription of Schedule III drugs after 6 months?

    <p>It must be rewritten</p> Signup and view all the answers

    What distinguishes Schedule I drugs from other schedules?

    <p>They have no accepted medical use</p> Signup and view all the answers

    Which substance is typically NOT classified under Schedule II despite its potential for abuse?

    <p>Ibuprofen</p> Signup and view all the answers

    Which type of pain is primarily associated with damage to tissues and can be exemplified by conditions such as arthritis or burns?

    <p>Nociceptive Pain</p> Signup and view all the answers

    Which classification of pain duration is characterized by lasting longer than 3 months?

    <p>Chronic Pain</p> Signup and view all the answers

    What is the maximum number of refills permitted for a Schedule V drug?

    <p>Up to 5 refills</p> Signup and view all the answers

    Which type of medications falls under Schedule IV classification with a low potential for abuse?

    <p>Soma and Xanax</p> Signup and view all the answers

    What would be the primary reason for someone to misinterpret the characteristics of mixed or undetermined etiology pain?

    <p>It is not associated with tissue damage</p> Signup and view all the answers

    Which of the following describes a common misconception about Schedule V drugs?

    <p>They encompass medications with the lowest potential for dependence.</p> Signup and view all the answers

    Which of these medications is an example of a Schedule IV drug that requires a prescription rewrite after 6 months?

    <p>Tramadol</p> Signup and view all the answers

    Which of the following statements accurately reflects the role of beta-blockers in headache management?

    <p>They provide symptomatic relief by preventing arterial dilation through beta-adrenergic blockade.</p> Signup and view all the answers

    How does Canakinumab differ from Colchicine in the management of gout?

    <p>Canakinumab specifically inhibits proinflammatory cytokines, whereas Colchicine acts on joint inflammation.</p> Signup and view all the answers

    What is the primary function of Topiramate in treating conditions associated with headache disorders?

    <p>To enhance GABA activity and reduce neuronal excitability.</p> Signup and view all the answers

    Which of the following medications is indicated specifically for the prophylactic treatment of gout?

    <p>Probenecid, which increases uric acid secretion to prevent attacks.</p> Signup and view all the answers

    What are the FDA-approved medications for treating Fibromyalgia known for?

    <p>Decreasing pain and fatigue while also being used for treating depression.</p> Signup and view all the answers

    What is one reason providers may undertreat pain in pediatric populations?

    <p>Providers believe children cannot accurately report pain.</p> Signup and view all the answers

    Which condition is frequently associated with increased rates of pain in elderly patients?

    <p>Arthritis</p> Signup and view all the answers

    What is a major concern regarding opioid use during pregnancy?

    <p>Potential for respiratory complications in newborns.</p> Signup and view all the answers

    What demographic is at increased risk for drug metabolism issues due to hepatic function decline?

    <p>Elderly patients</p> Signup and view all the answers

    Which statement best describes a safe method for managing pain in pediatric patients?

    <p>Non-pharmacological interventions should be attempted first.</p> Signup and view all the answers

    What is a unique legal concern when prescribing medications for one’s family?

    <p>Prescribing may risk the healthcare provider's professional license.</p> Signup and view all the answers

    What should be considered regarding the dosage adjustments in elderly patients receiving pain management?

    <p>Adjust the initial dose downward by 25% for those over 60.</p> Signup and view all the answers

    What risk is associated with infants when pain management is inadequately addressed?

    <p>Long-term effects on pain perception later in life.</p> Signup and view all the answers

    Why is it important to use caution with NSAIDs in certain populations?

    <p>They can lead to gastrointestinal bleeding especially in elderly patients.</p> Signup and view all the answers

    What is advised regarding the use of opioids in pain management during pregnancy?

    <p>They should be used only if absolutely necessary and for the shortest duration possible.</p> Signup and view all the answers

    What is a key teaching point for patients prescribed capsaicin cream?

    <p>It may burn initially but the sensation will fade.</p> Signup and view all the answers

    Which of the following classes of medications is specifically indicated for the treatment of post-herpetic neuralgia?

    <p>Capsicum</p> Signup and view all the answers

    What is the primary purpose of prophylactic medications for migraines?

    <p>To reduce the frequency and intensity of migraine attacks.</p> Signup and view all the answers

    What potential interaction should be monitored when prescribing Tylenol?

    <p>It may have dangerous interactions with medications containing acetaminophen.</p> Signup and view all the answers

    Which condition is NOT among the FDA-approved uses for medical marijuana?

    <p>Anxiety disorders</p> Signup and view all the answers

    Which mechanism is attributed to how triptans relieve migraine symptoms?

    <p>They activate 5-HT receptors to constrict blood vessels.</p> Signup and view all the answers

    What is a primary concern when using lidocaine as a local anesthetic?

    <p>It can cause a vasovagal response in patients experiencing pain or anxiety.</p> Signup and view all the answers

    What type of products should be combined cautiously due to the risk of toxicity?

    <p>Acetaminophen-containing products</p> Signup and view all the answers

    Which medication class is effective in treating symptoms of fibromyalgia?

    <p>Anticonvulsants</p> Signup and view all the answers

    Which assessment is important when considering medical marijuana recommendation?

    <p>Reviewing the patient's past substance abuse history.</p> Signup and view all the answers

    What is a common adverse effect of nasal decongestants?

    <p>Nasal dryness</p> Signup and view all the answers

    Why should nasal decongestants not be used for more than three days?

    <p>Risk of developing rhinitis medicamentosa</p> Signup and view all the answers

    Which side effect is particularly associated with oral decongestants?

    <p>Elevated heart rate</p> Signup and view all the answers

    What indication suggests the use of antitussives?

    <p>Patients with a nonproductive cough</p> Signup and view all the answers

    Which expectorant is commonly used to thin secretions?

    <p>Guaifenesin</p> Signup and view all the answers

    What should be encouraged alongside the use of expectorants for increased effectiveness?

    <p>Increased fluid consumption</p> Signup and view all the answers

    What is a key concern when using opioids for cough suppression?

    <p>Use in chronic obstructive pulmonary disease</p> Signup and view all the answers

    What is the primary action of nasal decongestants on adrenergic receptors?

    <p>Causing vasoconstriction</p> Signup and view all the answers

    What is the primary action of H1 receptor antagonists in treating upper respiratory symptoms?

    <p>They block the binding of histamine to H1 receptors.</p> Signup and view all the answers

    Which side effect is commonly associated with first-generation antihistamines?

    <p>Sedation and drowsiness</p> Signup and view all the answers

    What characteristic differentiates first-generation antihistamines from second-generation antihistamines?

    <p>First-generation antihistamines generally have greater central nervous system side effects.</p> Signup and view all the answers

    What symptom is NOT typically targeted by antihistamines in the context of a cold?

    <p>Fever</p> Signup and view all the answers

    What common mnemonic helps identify anticholinergic side effects?

    <p>Blind as a bat, dry as a bone</p> Signup and view all the answers

    What consequence can occur due to the anticholinergic effects of antihistamines?

    <p>Urinary retention</p> Signup and view all the answers

    Which statement is accurate regarding the duration of action of first-generation antihistamines?

    <p>They typically have an onset of action ranging from 15 to 30 minutes.</p> Signup and view all the answers

    What is a primary reason why first-generation antihistamines are less commonly used today?

    <p>They cause more pronounced sedation and cognitive side effects.</p> Signup and view all the answers

    What potential impact can oxymetazoline have on breastfeeding?

    <p>Reduce milk supply</p> Signup and view all the answers

    What is the most significant benefit of using montelukast (Singulair) as an add-on therapy?

    <p>It relieves nasal congestion more effectively when used with other medications.</p> Signup and view all the answers

    Which of the following antihistamines is considered the safest for use during pregnancy?

    <p>Chlorpheniramine</p> Signup and view all the answers

    What age group is montelukast (Singulair) approved for treating allergies?

    <p>6 months and older</p> Signup and view all the answers

    What is the primary concern when using large doses of diphenhydramine during breastfeeding?

    <p>Infant sedation and decreased milk supply</p> Signup and view all the answers

    Why must intranasal corticosteroids be used daily?

    <p>They need time to build up a barrier against allergic reactions.</p> Signup and view all the answers

    Why are 2nd generation non-sedating antihistamines preferred during breastfeeding?

    <p>They are less likely to cause infant sedation</p> Signup and view all the answers

    Which statement is true about cetirizine use in breastfeeding mothers?

    <p>Small, occasional doses are likely harmless</p> Signup and view all the answers

    What potential side effects are associated with montelukast (Singulair)?

    <p>Black Box Warning related to mood and behavior changes</p> Signup and view all the answers

    What is a recommended approach when prescribing antihistamines to breastfeeding mothers?

    <p>Administer doses after a feeding and before sleep</p> Signup and view all the answers

    How long does it take for intranasal corticosteroids to develop an effective barrier?

    <p>Five days</p> Signup and view all the answers

    What is the primary effect of blocking leukotrienes with medications like montelukast?

    <p>Relieving nasal congestion</p> Signup and view all the answers

    What is a common side effect associated with the use of sympathomimetics in conjunction with antihistamines?

    <p>Reduced milk supply</p> Signup and view all the answers

    What is a recommended course of action when starting intranasal steroids?

    <p>Start an oral antihistamine for the first five days</p> Signup and view all the answers

    What characteristic of beclomethasone affects infant exposure through maternal inhalation?

    <p>Low oral bioavailability</p> Signup and view all the answers

    What characteristic distinguishes intranasal corticosteroids from other allergy medications?

    <p>They must be used continuously for effectiveness.</p> Signup and view all the answers

    What is a key risk when using doxylamine during breastfeeding?

    <p>It may cause sedation in the infant.</p> Signup and view all the answers

    Why is codeine classified as a category C medication during pregnancy?

    <p>It has potential links to fetal malformations.</p> Signup and view all the answers

    What should be prioritized when prescribing narcotics to breastfeeding mothers?

    <p>Monitoring the infant for sedation and weight gain.</p> Signup and view all the answers

    What is a suggested approach for the use of codeine in breastfeeding mothers?

    <p>Use the smallest effective dose for the shortest duration.</p> Signup and view all the answers

    Why should antitussives be avoided in pregnancy?

    <p>They are linked to potential unknown side effects.</p> Signup and view all the answers

    What is a concerning effect of using narcotics in breastfeeding mothers?

    <p>Increased risk of maternal sedation.</p> Signup and view all the answers

    What do guaifenesin and dextromethorphan have in common regarding their use during pregnancy?

    <p>They are both classified as category C medications.</p> Signup and view all the answers

    What should be monitored closely in infants when a breastfeeding mother uses narcotics?

    <p>Weight gain and sedation levels.</p> Signup and view all the answers

    What is recommended regarding the use of medications that are known to be ineffective during pregnancy?

    <p>They should be avoided completely.</p> Signup and view all the answers

    Why should pseudoephredrine be avoided in the first trimester of pregnancy?

    <p>It has potential links to gastroschisis.</p> Signup and view all the answers

    What is a significant risk associated with prolonged use of oxymetazoline nasal spray?

    <p>Increased risk of rebound congestion.</p> Signup and view all the answers

    What is a possible effect of pseudoephedrine on breastfeeding mothers?

    <p>Decreased milk production with as little as one dose.</p> Signup and view all the answers

    Which of the following medications is categorized as category C and may have mixed safety data during pregnancy?

    <p>Phenylephrine</p> Signup and view all the answers

    What is the main consideration when using decongestants during pregnancy?

    <p>They should only be used if non-pharmacologic methods fail.</p> Signup and view all the answers

    What concern exists regarding the use of pseudoephedrine during lactation?

    <p>It may irritate infants and decrease milk supply.</p> Signup and view all the answers

    Which decongestant is a good first-line option but should be limited to three consecutive days of use?

    <p>Oxymetazoline</p> Signup and view all the answers

    Study Notes

    Drug Scheduling and Refill Requirements

    • Drugs are scheduled based on potential for abuse, misuse, and addiction.
    • Schedule I drugs have the highest abuse potential and no accepted medical use. Examples include heroin and LSD. Refills are not permitted.
    • Schedule II drugs have high abuse potential, but may have some medical use. Examples include combination products with less than 15 milligrams of hydrocodone per dosage unit (like Vicodin), cocaine and various other drugs. Refills are allowed with specific requirements (phone in emergency with written RX within 72 hours, electronic RX with secure ID).
    • Schedule III drugs have moderate to low abuse potential and accepted medical applications. Examples include products containing less than 90 milligrams of codeine per dosage unit. Refills are permitted up to 5 refills.
    • Schedule IV and V drugs have the lowest abuse potential for abuse and low risk of dependence. Examples include combinations with codeine, Xanax, Soma, Darvon, etc. Refills are allowed up to 5 refills.

    Types of Pain

    • Nociceptive Pain: Pain from damage to tissues (e.g., burns, appendicitis, pancreatitis).
    • Neuropathic Pain: Nerve-related pain (e.g., diabetes, alcoholism, cancer, regional pain syndromes).
    • Mixed or Undetermined Etiology: Chronic pain with complex causes (e.g., chronic headaches, vasculitis).

    Pain Management in the Elderly

    • Unique concerns include renal and liver function limitations affecting drug metabolism.
    • Increased risk of gastrointestinal bleeding with non-steroidal anti-inflammatory drugs (NSAIDs)
    • Comorbidities can interact with pain medications, especially in the elderly.
    • Dose adjustments may be necessary for the elderly.

    Concerns about Pain Management in Pregnancy and Lactation

    • Opioid use during pregnancy can increase risks for neural tube defects, miscarriage, and preterm birth
    • If opioids are needed, the lowest effective dose for the shortest duration should be used.

    Acetaminophen Concerns

    • Maximum adult dose is 4,000 mg/day
    • Important for patients to understand that combining acetaminophen with other medications or products can lead to accidental overdoses or allergic reactions.

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    Description

    This quiz covers the classification of drugs based on their potential for abuse and medical use. Learn about the different schedules from I to V, including the refilling regulations for each category. This information is essential for understanding drug management in medical practice.

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