Pharmacology Class Quiz
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Questions and Answers

What is a primary disadvantage of enteral routes of drug administration?

  • Higher bioavailability compared to parenteral routes
  • Direct infusion into systemic circulation
  • Invasiveness requiring trained personnel
  • Slow absorption and low bioavailability due to first-pass metabolism (correct)

    • Which factor does NOT influence drug distribution?

  • Plasma protein binding
  • Age of the patient
  • Time of day (correct)
  • Molecular size and shape

    • How does intravenous injection compare to intramuscular injection in terms of absorption?

  • Faster absorption because it bypasses the gastrointestinal tract (correct)
  • Slower absorption due to muscle perfusion
  • Increased risk of embolism compared to intramuscular injection
  • Similar absorption rates but less invasive

    • Which type of drug is more likely to readily cross cell membranes during distribution?

    <p>Lipophilic (fat-soluble) drugs</p> Signup and view all the answers

    What is one of the major barriers to absorption for oral medications?

    <p>Degradation in the gastrointestinal tract</p> Signup and view all the answers

    Which determinant of drug distribution limits a drug’s ability to leave the vascular system?

    <p>Plasma protein binding</p> Signup and view all the answers

    Which route of administration is considered non-invasive and convenient for self-administration?

    <p>Oral route</p> Signup and view all the answers

    Which condition can influence the distribution of specific drugs in the body?

    <p>Body composition</p> Signup and view all the answers

    Which of the following is a key function of antidotes used in neuropathic pain management?

    <p>Suppressing spontaneous neuronal firing</p> Signup and view all the answers

    What is the primary use of bisphosphonates in cancer pain management?

    <p>Reduce bone pain and prevent skeletal complications</p> Signup and view all the answers

    Which class of drugs can help with both neuropathic pain and comorbid depression?

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

    What is the function of topical agents in treating neuropathic pain?

    <p>Offer localized pain relief</p> Signup and view all the answers

    What procedure involves injecting local anesthetics near specific nerves to alleviate pain?

    <p>Nerve block</p> Signup and view all the answers

    Which of the following is an example of a neurolytic procedure?

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

    How do cannabinoids function in the context of cancer pain management?

    <p>They are used as adjuncts for pain relief and appetite stimulation</p> Signup and view all the answers

    Why is careful patient selection critical in pain management procedures?

    <p>For optimal outcomes in effective pain relief</p> Signup and view all the answers

    What is the first-line approach for treating pediatric pain?

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

    What is a key consideration when managing pain in patients with opioid use disorder?

    <p>Avoid mixed agonist-antagonists</p> Signup and view all the answers

    Which of the following is NOT a recommended component of patient education for cancer pain management?

    <p>Advising patients to avoid discussing fears</p> Signup and view all the answers

    In treating pediatric pain, which option reflects a critical aspect of engaging with caregivers?

    <p>Involving caregivers can enhance understanding and compliance</p> Signup and view all the answers

    What role do adjuvant medications play in pain management?

    <p>They may be added for neuropathic pain alongside other therapies</p> Signup and view all the answers

    Why is it important to calculate opioid dosing based on weight?

    <p>To avoid underdosing in lightweight patients</p> Signup and view all the answers

    What is one of the key benefits of comprehensive patient education in pain management?

    <p>It enhances compliance and reduces anxiety</p> Signup and view all the answers

    Which statement about non-drug therapies in pain management is accurate?

    <p>They can complement pharmacological treatments effectively</p> Signup and view all the answers

    What is a common negative effect experienced by approximately 50% of patients using sumatriptan?

    <p>Chest symptoms like heaviness</p> Signup and view all the answers

    Which classification of drugs should not be combined with sumatriptan due to the risk of increased toxicity?

    <p>Selective Serotonin Reuptake Inhibitors (SSRIs)</p> Signup and view all the answers

    What adverse effect of sumatriptan is considered very rare, particularly in patients with risk factors for coronary artery disease?

    <p>Coronary vasospasm and angina</p> Signup and view all the answers

    Which of the following triptan medications is also known as Maxalt?

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

    What mechanism differentiates lasmiditan from traditional triptans like sumatriptan?

    <p>Binds to 5-HT1F receptors</p> Signup and view all the answers

    Which of the following is NOT a reported side effect of lasmiditan?

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

    What is a notable property of lasmiditan regarding its classification?

    <p>It is classified as a Schedule V controlled substance</p> Signup and view all the answers

    What type of medication is lasmiditan approved to treat?

    <p>Acute treatment of migraine</p> Signup and view all the answers

    What is the primary action of topiramate in migraine prevention?

    <p>Antagonizing glutamate receptors</p> Signup and view all the answers

    Which of the following is a common side effect of tricyclic antidepressants used for migraine prevention?

    <p>Blurred vision</p> Signup and view all the answers

    How do cluster headaches primarily differ from migraine headaches in terms of duration?

    <p>Migraine headaches last longer than cluster headaches</p> Signup and view all the answers

    What is the typical initial dosage range of amitriptyline for migraine prevention?

    <p>25-150mg daily</p> Signup and view all the answers

    Which treatment is NOT commonly used for acute relief of migraines?

    <p>Oxygen therapy</p> Signup and view all the answers

    What neurotransmitter's reuptake do tricyclic antidepressants inhibit in migraine pathways?

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

    What is the preventive treatment for cluster headaches?

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

    What is a characteristic symptom of cluster headaches that is not typically associated with migraines?

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

    What is one major symptom of FGA overdose?

    <p>Acute dystonia</p> Signup and view all the answers

    Which treatment is commonly considered for severe extrapyramidal reactions due to FGA overdose?

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

    Which of the following is a key characteristic differentiating high potency FGAs from low potency FGAs?

    <p>Low potency FGAs require higher doses for effect.</p> Signup and view all the answers

    What is a primary pharmacologic property of second-generation antipsychotics (SGAs)?

    <p>Moderate dopamine D2 receptor blockade</p> Signup and view all the answers

    Which effect is associated with the higher 5-HT2A/D2 binding ratio in SGAs?

    <p>Efficacy enhancement</p> Signup and view all the answers

    What does FGA stand for in the context of antipsychotic medications?

    <p>First-generation antipsychotics</p> Signup and view all the answers

    Which condition may occur as a potential fatal complication of FGA overdose?

    <p>Respiratory depression</p> Signup and view all the answers

    What is the focus of management in FGA overdose cases?

    <p>Symptom treatment until drug elimination</p> Signup and view all the answers

    What type of pain is often characterized by allodynia and hyperalgesia?

    <p>Neuropathic pain</p> Signup and view all the answers

    Which type of pain results primarily from direct involvement of surrounding tissues by tumors?

    <p>Direct tumor involvement</p> Signup and view all the answers

    Which of the following is less likely to respond to traditional analgesics like NSAIDs?

    <p>Neuropathic pain</p> Signup and view all the answers

    What type of pain is characterized by sensations described as burning or electric-like?

    <p>Neuropathic pain</p> Signup and view all the answers

    Which category of cancer pain is associated with anxiety or depression exacerbating pain perception?

    <p>Psychological factors</p> Signup and view all the answers

    What type of pain can result from chemotherapy leading to conditions like mucositis or neuropathy?

    <p>Treatment-related pain</p> Signup and view all the answers

    Which type of pain requires individualized treatment approaches due to its multifactorial nature?

    <p>Cancer pain</p> Signup and view all the answers

    Which type of pain might result from complications associated with assessing a patient's condition through interventions?

    <p>Procedural pain</p> Signup and view all the answers

    What is a critical action a nurse should take to minimize adverse drug interactions?

    <p>Obtain a comprehensive medication history from the patient.</p> Signup and view all the answers

    How can knowledge of pharmacokinetics aid in managing a patient’s medication?

    <p>It guides dosage adjustments to prevent toxicity.</p> Signup and view all the answers

    What aspect of nursing care is paramount when administering PRN drugs?

    <p>Assessing the patient’s need through subjective and objective data.</p> Signup and view all the answers

    Which of the following represents a proactive strategy for managing medication side effects?

    <p>Educating patients on the mechanism of action of their medications.</p> Signup and view all the answers

    In the context of patient education, what resource might assist patients in avoiding drug interactions?

    <p>Medication interaction checkers.</p> Signup and view all the answers

    What key responsibility do nurses have when new medications are prescribed to patients?

    <p>Collaborate with the healthcare team to adjust medication regimens.</p> Signup and view all the answers

    Why is it essential for a nurse to monitor patients closely for signs of drug interactions?

    <p>To identify and address potential interactions, especially when medications are added.</p> Signup and view all the answers

    What determines a nurse's clinical judgment in administering PRN medications?

    <p>Patient’s reported symptoms and objective data.</p> Signup and view all the answers

    What characterizes buprenorphine's action at the mu-opioid receptor?

    <p>It is a partial agonist with a ceiling effect.</p> Signup and view all the answers

    What is the typical onset time for immediate-release hydrocodone?

    <p>20-30 minutes</p> Signup and view all the answers

    Which of the following statements is true regarding the metabolism of both oxycodone and hydrocodone?

    <p>Both are metabolized by CYP3A4 and CYP2D6 enzymes.</p> Signup and view all the answers

    What effect does hydrocodone typically have when used for cough suppression?

    <p>It suppresses the cough reflex effectively.</p> Signup and view all the answers

    What is a defining feature of extended-release formulations of hydrocodone?

    <p>They are designed for once-daily dosing.</p> Signup and view all the answers

    Which of the following is a common side effect shared by both hydrocodone and oxycodone?

    <p>Respiratory depression</p> Signup and view all the answers

    What unique property of buprenorphine contributes to its lower risk of overdose compared to full agonist opioids?

    <p>It possesses a ceiling effect on respiratory depression.</p> Signup and view all the answers

    Which of the following correctly describes the control classification of hydrocodone combination products?

    <p>Schedule II due to their moderate abuse potential.</p> Signup and view all the answers

    Which route of fentanyl administration is specifically indicated for breakthrough cancer pain in opioid-tolerant patients?

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

    What is a key limitation of meperidine compared to morphine regarding its duration of action?

    <p>Meperidine has a faster onset but shorter duration of action.</p> Signup and view all the answers

    What risk is increased when morphine is combined with monoamine oxidase inhibitors (MAOIs)?

    <p>Risk of serotonin syndrome</p> Signup and view all the answers

    Which of the following applies to fentanyl administered parenterally?

    <p>Indicated for induction and maintenance of surgical anesthesia.</p> Signup and view all the answers

    Which adverse effect of meperidine is closely linked to its metabolite, normeperidine?

    <p>Neurotoxicity, including seizures</p> Signup and view all the answers

    How does the interaction between morphine and antihypertensive agents typically manifest?

    <p>Decreased blood pressure</p> Signup and view all the answers

    What characterizes the transdermal route of fentanyl administration?

    <p>Useful for stable, chronic pain control.</p> Signup and view all the answers

    In which situation should meperidine be avoided due to potential life-threatening interactions?

    <p>In patients taking MAOIs</p> Signup and view all the answers

    Which non-drug therapy is primarily aimed at altering pain perceptions and providing a sense of control?

    <p>Mindfulness meditation</p> Signup and view all the answers

    Which characteristic symptom is specifically associated with migraine headaches?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What type of medication is considered first-line for abortive therapy of moderate to severe migraine attacks?

    <p>Triptans such as sumatriptan</p> Signup and view all the answers

    What is the role of complementary and alternative medicine (CAM) approaches in pain management?

    <p>Combine active and passive techniques to address pain pathways effectively</p> Signup and view all the answers

    How are nonspecific analgesics like NSAIDs utilized in acute migraine management?

    <p>For mild to moderate attacks only</p> Signup and view all the answers

    What is a key characteristic of a migraine aura?

    <p>Sensory disturbances that can occur before the headache phase</p> Signup and view all the answers

    Which statement accurately summarizes the typical frequency of migraine attacks?

    <p>Average around 1.5 times per month</p> Signup and view all the answers

    Which physical therapy approach can help improve physical function and reduce pain-related immobility?

    <p>Hot compress application</p> Signup and view all the answers

    What characterizes drugs with a wide therapeutic index?

    <p>They safely allow for significant dosing errors.</p> Signup and view all the answers

    Which of the following is a primary effect of activating mu (μ) opioid receptors?

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

    What distinguishes agonist-antagonist opioids from pure opioid agonists?

    <p>Agonist-antagonist opioids can precipitate withdrawal symptoms.</p> Signup and view all the answers

    Which is true regarding kappa (κ) receptors?

    <p>Their activation leads to sedation but less euphoria.</p> Signup and view all the answers

    How does the safety profile of drugs with a narrow therapeutic index compare to those with a wide therapeutic index?

    <p>Narrow therapeutic index drugs have a higher risk of toxicity.</p> Signup and view all the answers

    What is a consequence of using agonist-antagonist opioids improperly with pure opioids?

    <p>Precipitation of withdrawal symptoms.</p> Signup and view all the answers

    Why are mu (μ) receptors the primary focus in opioid analgesics?

    <p>They mediate the most significant effects in pain relief.</p> Signup and view all the answers

    Which characterizes endogenous opioid peptides in relation to delta (δ) receptors?

    <p>They do not modulate analgesia but affect emotional responses.</p> Signup and view all the answers

    Study Notes

    Enteral Drug Administration Disadvantage

    • Potential for first-pass metabolism: Drugs administered orally pass through the liver before reaching systemic circulation, which can significantly reduce their bioavailability (amount available to the body).

    Factors Influencing Drug Distribution

    • Drug's affinity for plasma proteins: Drugs bind to proteins in the blood. Only unbound drugs are free to distribute to tissues.

    Intravenous vs. Intramuscular Injection

    • Intravenous injection: Immediate absorption into the bloodstream – fast onset of action.
    • Intramuscular injection: Absorption is slower, but more sustained release than intravenous.

    Types of Drugs Crossing Cell Membranes

    • Lipid-soluble drugs: More likely to cross cell membranes, as they can dissolve in the lipid bilayer of cell membranes.

    Barriers to Oral Medication Absorption

    • First-pass metabolism in the liver: A significant amount of the drug can be metabolized in the liver before it reaches systemic circulation.

    Factors Limiting Drug Distribution

    • Blood-brain barrier: A protective barrier that limits the passage of drugs from the bloodstream into the brain.

    Non-Invasive and Convenient Self-Administration

    • Oral administration: Swallowing tablets or capsules is easy for self-administration without need for needles.

    Conditions Influencing Drug Distribution

    • Pregnancy: Physiological changes during pregnancy can affect drug distribution, including increased blood volume and changes in protein binding.

    Antidote Function in Neuropathic Pain

    • To reverse the effects of a specific medication: Antidotes are used to counter the toxic effects of certain drugs.

    Bisphosphonate Use in Cancer Pain

    • To reduce bone pain caused by bone metastases (cancer spreading to bones): Bisphosphonates work by inhibiting bone resorption and reducing bone turnover.

    Drugs for Neuropathic Pain and Depression

    • Tricyclic antidepressants (TCAs): Useful for both neuropathic pain and depression due to their dual action on neuronal pathways.

    Topical Agents for Neuropathic Pain

    • Provide localized pain relief: These agents target specific areas of the body affected by neuropathic pain, minimizing systemic side effects.

    Nerve Block Procedure

    • Perineural injection: Local anesthetics are injected near specific nerves to block pain signals transmitting to the brain.

    Neurolytic Procedure Example

    • Alcohol injection: Alcohol can be injected into specific nerves to destroy them and eliminate pain signals.

    Cannabinoid Function in Cancer Pain

    • Modulate pain perception: Cannabinoids can activate receptors in the nervous system to reduce pain perception.

    Critical Patient Selection for Pain Management

    • To optimize treatment outcomes and minimize risks: Patient selection ensures procedures are appropriate for individual needs and conditions.

    First-Line Pediatric Pain Treatment

    • Non-pharmacological approaches: These methods like distraction, relaxation techniques, and positioning are preferred for initial pain management in children.

    Opioid Use Disorder Pain Management

    • Non-opioid pain management: Focus remains on alternative pain methods like non-pharmacological approaches and non-opioid analgesics.
    • Delaying pain management until after diagnosis: Immediate and thorough pain management is essential to improve quality of life.

    Engaging with Caregivers in Pediatric Pain Management

    • Collaboration and shared decision-making: Open communication with caregivers allows for a comprehensive understanding of the child's needs and preferences.

    Adjuvant Medications in Pain Management

    • Enhance the effects of primary analgesics: Adjuvants can enhance pain relief or address specific symptoms like nausea or anxiety.

    Opioid Dosing Based on Weight

    • Prevent overdose and achieve optimal pain relief: Weight-based dosing ensures a safe and effective medication dose.

    Comprehensive Patient Education Benefit

    • Improved medication adherence and self-management skills: Well-informed patients are better equipped to manage their pain and optimize treatment outcomes.

    Non-drug Therapies in Pain Management

    • They are increasingly recognized as a valuable part of a comprehensive pain management plan: Non-drug therapies can offer benefits to manage pain and improve overall function.

    Common Sumatriptan Side Effect

    • Dizziness: This side effect is experienced by approximately 50% of patients using sumatriptan.

    Medications To Avoid Combining with Sumatriptan

    • Ergot alkaloids: Combining these with sumatriptan can increase the risk of vasoconstriction and potentially lead to cardiovascular complications.

    Rare Sumatriptan Adverse Effect

    • Coronary vasospasm: This event is very rare, but risk factors like coronary artery disease increase its possibility.

    Name (Brand) of a Triptan Medication

    • Rizatriptan: Also known as Maxalt, this medication is used to treat migraines.

    Mechanism of Action of Lasmiditan

    • Selective 5-HT1F receptor agonist: Lasmiditan targets a specific serotonin receptor in the brain, unlike traditional triptans that work on various serotonin receptors.

    Lasmiditan Side Effect Not Reported

    • Hallucination: This is not a reported side effect of lasmiditan.

    Lasmiditan Classification Property

    • Non-triptan: While effective for migraines, lasmiditan structurally differs from traditional triptans.

    Lasmiditan Approved Use

    • Adult migraine with or without aura: Lasmiditan is indicated for acute treatment of migraine events in adults.

    Topiramate's Action in Migraine Prevention

    • Blocks voltage-gated sodium channels: Topiramate's mechanism contributes to its effectiveness in reducing migraine frequency and severity.

    Common Tricyclic Antidepressant Side Effect

    • Sedation: A common side effect of tricyclic antidepressants (TCAs) used for migraine prevention.

    Cluster Headache Duration vs. Migraine Duration

    • Cluster headaches: Characterized by periods of intense pain lasting from 15-180 minutes.
    • Migraines: Usually last for several hours to days.

    Amitriptyline's Initial Dosage for Migraine Prevention

    • 10-25mg at bedtime: This is a typical starting dose, with adjustments based on individual response and tolerance.

    Treatment Not Used for Acute Migraines

    • Anti-epileptic medications: These are primarily used for migraine prevention, not acute relief.

    Neurotransmitter Affected by Tricyclic Antidepressants

    • Serotonin: While targeting various neurotransmitters, tricyclic antidepressants affect serotonin reuptake in migraine pathways.

    Cluster Headache Preventive Treatment

    • Oxygen therapy: High-flow oxygen administration is a primary preventive treatment for cluster headaches.

    Characteristic Cluster Headache Symptom

    • Unilateral facial pain: Pain often focuses on one side of the face, while migraine pain can be unilateral or bilateral.

    Major Symptom of FGA Overdose

    • Extrapyramidal symptoms (EPS): These are involuntary movements resulting from dopamine blockade, and can be severe in overdose.

    Treatment for Severe EPS

    • Anticholinergic medications: Used to relieve EPS by counteracting the effects of dopamine blockage.

    High vs. Low Potency FGAs: Key Characteristic

    • Potency refers to the relative amount of dopamine blockade: High-potency FGAs (higher doses = same effect) are associated with a higher risk of EPS.

    Pharmacologic Property of SGAs

    • Partial agonism at dopamine receptors: SGAs possess a weaker dopamine blockade compared to FGAs, contributing to a lower risk of EPS and metabolic side effects.

    SGAs: Effect Associated with Binding Ratio

    • Lower risk of extrapyramidal symptoms (EPS): The higher 5-HT2A/D2 binding ratio in SGAs suggests a better balance of serotonin and dopamine activity, reducing EPS.

    Meaning of FGA

    • First-generation antipsychotics: The older, more potent antipsychotics, commonly associated with dopamine receptor antagonism.

    Potential Fatal Complication of FGA Overdose

    • Neuroleptic malignant syndrome: This is a potentially life-threatening neurological disorder characterized by fever, muscle rigidity, and altered mental status.

    Focus of Management in FGA Overdose

    • Supporting vital functions and managing symptoms: Treatment aims to stabilize the patient's condition and prevent further complications.

    Characterization of Allodynia and Hyperalgesia

    • Neuropathic pain: This type of pain often manifests as allodynia (pain from non-painful stimuli) and hyperalgesia (exaggerated response to painful stimuli).

    Pain from Tumor Involvement

    • Somatic pain: Direct involvement of surrounding tissues by tumors leads to intense pain localized to the affected area.

    Less Likely to Respond to Traditional Analgesics

    • Neuropathic pain: NSAIDs and other traditional analgesics may have limited effectiveness in addressing neuropathic pain.

    Sensation Characteristic of Burning or Electric-Like Pain

    • Neuropathic pain: These atypical pain sensations are commonly associated with nerve damage or dysfunction.

    Anxiety and Depression Exacerbating Pain

    • Psychogenic pain: Pain perception is heightened by psychological factors, creating a vicious cycle where anxiety and depression exacerbate the pain experience.
    • Cancer-related pain: Chemotherapy's side effects can lead to pain, including mucositis (inflammation of the mouth), neuropathy (nerve damage), and musculoskeletal pain.

    Pain Requiring Individualized Treatment

    • Cancer pain: The multifaceted nature of cancer pain necessitates individualized treatment plans tailored to the patient's unique needs and symptoms.

    Pain from Patient Assessment Complications

    • Procedural pain: Pain can arise from interventions or testing performed during the assessment process, emphasizing the need for careful procedures and pain management strategies.

    Nurse Action to Minimize Drug Interactions

    • Reviewing the patient's medication history: A comprehensive review of past and current medications helps identify potential drug interactions and guide safe and effective treatment.

    Pharmacokinetics and Medication Management

    • Understanding pharmacokinetics aids in optimizing drug dosage: Understanding the drug's absorption, distribution, metabolism, and elimination allows for informed decisions regarding dosage and timing.

    PRN Drug Administration

    • Evaluating the patient's condition for administering PRN drugs: Nurses must carefully assess the patient's pain level, current medications, and overall medical status before administering PRN medications.

    Proactive Side Effect Management Strategy

    • Monitoring for potential side effects: Regular monitoring of patients for known side effects allows for early identification and intervention to manage adverse reactions.

    Resource for Avoiding Drug Interactions

    • Medication guide and patient education materials: Providing patients with clear and accessible information about their medications helps them understand potential interactions and avoid them.

    Nurse Responsibility with New Prescriptions

    • Educating patients about new medications: Nurses play a vital role in informing patients about medication purpose, dosage, potential side effects, and interactions.

    Nurse Monitoring Drug Interactions

    • Ensure patient safety and optimal therapeutic outcomes: Monitoring for drug interactions helps prevent potentially serious adverse effects.

    Basis for PRN Medication Administration

    • Patient's individual needs and assessment findings: Clinical judgment is crucial for administering PRN drugs, considering the patient's pain level, overall condition, and medication history.

    Buprenorphine Action at Mu-Opioid Receptor

    • Partial agonist: Buprenorphine binds to the mu-opioid receptor, producing less intense effects compared to full agonists.

    Onset Time for Immediate-Release Hydrocodone

    • 15-30 minutes: Immediate-release formulations of hydrocodone produce pain relief within this time frame.

    Metabolism of Oxycodone and Hydrocodone

    • Both medications are metabolized through CYP3A4: This enzyme plays a significant role in their metabolism, potentially leading to drug interactions.

    Effects of Hydrocodone for Cough Suppression

    • Suppresses the cough reflex: Hydrocodone is often used for cough suppression due to its antitussive properties.

    Feature of Extended-Release Hydrocodone

    • Sustained pain relief for 12 hours or more: Extended-release formulations offer longer-lasting pain relief compared to immediate-release options.

    Common Side Effect of Hydrocodone and Oxycodone

    • Constipation: This is a common side effect associated with both hydrocodone and oxycodone, related to their opioid effects.

    Buprenorphine's Low Overdose Risk Feature

    • Ceiling effect: Buprenorphine's affinity to the mu-receptor limits its effects, preventing excessive respiratory depression even with high doses.

    Control Classification of Hydrocodone Combination Products

    • Schedule II: These products are classified as Schedule II controlled substances due to their potential for abuse and dependence.

    Fentanyl Administration for Breakthrough Pain

    • Sublingual: Sublingual fentanyl is specifically indicated for breakthrough cancer pain in opioid-tolerant patients.

    Meperidine vs. Morphine Limitation

    • Shorter duration of action: Meperidine has a shorter duration of action compared to morphine, requiring more frequent administration.

    Increased Risk with Morphine and MAOIs

    • Serotonin syndrome: Combining morphine with MAOIs can lead to the development of a potentially life-threatening condition characterized by confusion, agitation, and hyperthermia.

    Fentanyl Administration Route

    • Parenteral: Fentanyl can be administered intravenously, intramuscularly, or subcutaneously for pain management.
    • Neurotoxicity: Normeperidine, a metabolite of meperidine, can accumulate in the body and cause seizures or neurotoxicity, especially in patients with renal impairment.

    Interaction of Morphine and Antihypertensive Agents

    • Increased hypotensive effects: Combining morphine with antihypertensive medications can lead to excessive blood pressure lowering due to their synergistic effects on blood vessel dilation.

    Transdermal Fentanyl Administration

    • Continuous, sustained pain relief over 72 hours: Transdermal fentanyl patches provide slow, continuous release of the drug, minimizing the need for frequent dosing.

    Situation Where Meperidine Should Be Avoided

    • In patients with renal impairment or receiving medications metabolized by CYP2D6: Meperidine is not recommended in these situations to reduce the risk of normeperidine accumulation and neurotoxicity.

    Non-Drug Therapy for Pain Perception

    • Mindfulness-based therapies: Techniques like mindfulness meditation and yoga aim to alter pain perception and improve coping mechanisms.

    Characteristic Symptom of Migraine Headaches

    • Pulsating or throbbing pain: Migraines are often accompanied by a throbbing or pulsating pain, frequently described as a severe headache.

    First-Line for Moderate to Severe Migraines

    • Triptans: These medications are considered first-line for abortive therapy of moderate to severe migraine attacks.

    CAM in Pain Management

    • Complementary and alternative medicine (CAM): Offers a variety of non-pharmacological approaches for pain management, often used alongside conventional therapies.

    NSAIDs in Acute Migraine Management

    • Reduce inflammation and pain: NSAIDs help to manage the pain and inflammation associated with migraines.

    Migraine Aura Characteristic

    • Visual disturbances: An aura is a sensory disturbance that precedes a migraine attack, often involving visual changes like flashing lights or blind spots.

    Migraine Attack Frequency

    • Variable: Migraine attack frequencies can range from a few times a year to several times a month.

    Physical Therapy for Pain Relief

    • Therapeutic exercise: Specifically tailored exercises can help improve physical function, decrease pain-related immobility, and enhance overall well-being.

    Wide Therapeutic Index Property

    • Safe margin between effective dose and toxic dose: Drugs with a wide therapeutic index allow for greater flexibility in dosing.

    Primary Mu-Opioid Receptor Activation Effect

    • Analgesia and euphoria: Activating mu-opioid receptors produces pain relief and feelings of euphoria.

    Agonist-Antagonist Opioids vs. Pure Agonists

    • Partial agonist properties: Agonist-antagonist opioids only partially activate the mu-receptor, reducing risk of overdose when used with pure opioids.

    Kappa (κ) Receptors

    • Play a role in analgesia, dysphoria, and sedation: Kappa receptors are involved in pain modulation, but their activation can lead to dysphoria or adverse effects.

    Safety Profile of Drugs with Narrow Therapeutic Index

    • Lower safety margin: Drugs with a narrow therapeutic index have a small margin between an effective dose and a toxic dose, requiring careful monitoring.

    Consequence of Agonist-Antagonist Misuse

    • Precipitated withdrawal: Mixing agonist-antagonist opioids with pure opioid agonists can trigger withdrawal symptoms in individuals with opioid dependence.

    Why Mu (μ) Receptors are Primary Opioid Focus

    • Strongest analgesic effects: Mu receptors mediate the most potent pain-reducing effects among opioid receptors.

    Endogenous Opioid Peptides and Delta (δ) Receptors

    • Endogenous opioids bind to delta (δ) receptors: These naturally occurring peptides play a role in various physiological processes, including pain modulation.

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