First Test

Question 1

Blood brain barrier

Answer 1

Only lipid soluble drugs cross the barrier, the blood brain barrier is relatively in peneturable, usually protective

Question 2

I Can PresCribE A Drug

Answer 2

Indication 
Contraindications 
Precautions 
Cost/compliance 
Efficacy 
Adverse effects 
Dose/duration/direction

Question 3

Controlled substance schedule I

Answer 3

No accepted medical use
No legal use permitted
For registered research facilities only
Ie- heroin, lsd, marijuana

Question 4

Controlled substance II

Answer 4

No refills permitted
Written prescriptions only no telephone orders
Prescriptions expire 72 hours if not filled
Ie- narcotic, stimulants- cocaine, amphetamine, methylphenidate
Depressants- pentobarbital, secobarbital

Question 5

Controlled substance III

Answer 5

Prescriptions must be rewritten after 6 months or 5 refills- telephone prescriptions accepted
Ie- narcotics and stimulants

Question 6

Controlled substances IV

Answer 6

Same as III, penalties for illegal possession are different

Question 7

Controlled substances V

Answer 7

Same as all prescription drugs may be dispensed without a prescription unless regulated by the state
Ie- loperamide, diphenoxylate

Question 8

Adverse drug reaction

Answer 8

An adverse drug reaction is any undesirable or unintended effect occurring after administration of a medical product

Question 9

What are the two types of adverse drug reactions

Answer 9

Pharmacological which is 85% of 90% of adverse drug reactions and idiosyncratic or unpredictable

Question 10

Type one allergic response

Answer 10

Question 11

Type two allergic response

Answer 11

Question 12

Tape three allergic response

Answer 12

Question 13

Type 4allergic response

Answer 13

Question 14

Pain involves the interactions of three major systems

Answer 14

Sensory/discriminative
Motivational/affective
Cognitive/ evaluative

Question 15

Pain threshold

Answer 15

The point at which that stimulus is experienced as pain it differs from person to person

Question 16

Pain tolerance

Answer 16

The duration of time or the intensity of pain that a person will endure before taking over action to relieve the pain. Decreases with repeated exposure to pain. Decreased by fatigue anger fear and sleep deprivation

Question 17

Acetaminophen

Answer 17

Action: Work centrally in the central nervous system to inhibit prostaglandin. Used for mild to moderate pain. Safer than NSAIDs for most. Safe in pregnancy is. Save an infant. Safe and most older adults

Question 18

Cox inhibitors

Answer 18

NSAIDS- ketorolac, naproxen, ibuprofen
Salicylates: aspirin
COX-2 inhibitors- celecoxib (celebrex)

Question 19

NSAIDS

Answer 19

Action is to inhibit proto Landon formation. Used for fever pain inflammation anti platelet. Not all have the same action

Question 20

Avoid NSAIDs in pregnancy older adults in renal dysfunction. True or false

Answer 20

True

Question 21

Drug interactions for NSAIDs are

Answer 21

Alcohol, anticoagulants, and antiplatelets

Question 22

Salicylates aspirin

Answer 22

Action is to inhibit prostaglandin formation. It is used for fever pain inflammation and anti-platelet

Question 23

Adverse drug reactions for aspirin include

Answer 23

G.I. upset abdominal pain G.I. bleed renal impairment and tinnitus

Question 24

Celebrex or Cox – 2inhibitors

Answer 24

Action is to inhibit prostaglandin formation it is used for pain, and information

Question 25

Celebrex is used with caution in patients with

Answer 25

Congestive heart failure, hypertension, and fluid retention

Question 26

Phase 1 assessment for prescribing pain medication

Answer 26

Begin with a chief complaint that identifies the impact of the pain. Sleep disturbances, secondary physical problem, anxiety, depression, cognitive disorders, stress and functional disabilities. He was a pain scale. Use non-pharmacological strategies. Refer to the state board of pharmacy prescription drug monitoring program report

Question 27

Phase 2. Trial of an opioid

Answer 27

Non-opioid therapy is preferred. Prior to initiating therapy sign the patient provider agreement and the informed consent form. Set realistic goals. Start with immediate release opioid when starting therapy. Start low, and go slow. Consider naloxone prescription

Question 28

Phase 3. Long-term treatment.

Answer 28

End of trial and onto chronic management. Patient has satisfactory pain relief. Patient can manage ADLs. There are consistent pain scores unreliable skills. There are no misuses. There are no legal issues or incarcerations. Patient is not relocating.

Question 29

Phase 4. Termination of chronic opioid treatment.

Answer 29

Play some ethical decision making, driven by practice policies, and discussions and decisions are documented. Minimization withdrawal symptoms. Abrupt sensation can lead to seizures or withdrawal symptoms examples are nausea diarrhea muscle pain and myclonus