Opioid Prescribing and Prescription Monitoring

Question 1

More men or women abuse opioids?

Answer 1

Women

Question 2

States with the highest opiod prescriptions.

Answer 2

NY, California, Florida

Question 3

Vast majority of opioid deaths are people of what gender and ethnicity?

Answer 3

Caucasian males

Question 4

Most opioid deaths are from which drug?

Answer 4

Fentanyl

Question 5

Three settings in dentistry where opioids and non-opioid analgesics are used:

Answer 5

1) To alleviate acute pain.
2) To alleviate non-cancer chronic pain.
3) To alleviate cancer pain.

Question 6

Pain has to be present for how many weeks to be considered chronic?

Answer 6

12 weeks

Question 7

• Pain that resolves with healing.
• Is related to tissue damage.
• Expected to resolve within days to weeks.

Answer 7

Acute pain

Question 8

Non-pharmacologic approaches to managing pain.

Answer 8

• Behavioral management
• Physical Therapy (Uce, heat, positioning, stretching and directed exercise, chiropractic, osteopathic).
• Self-management techniques (biofeedback, hypotherapy).

Question 9

Opioids interfere with which pathway?

Answer 9

Integration at the CNS/brain

Question 10

Local anesthesia interferes with which pathway?

Answer 10

Transmission

Question 11

NSAIDs interfere with this pathway.

Answer 11

Initiation (nociceptor)

Question 12

This COX is induced by inflammatroy cytokines, growth factors, and tumor promoters.

Answer 12

COX 2

Question 13

This COX is constitutively expressed in mammalian tissues and PG’s are essential for physiologic function (gastric protection, platelet aggregation, and renal function).

Answer 13

COX 1

Question 14

NSAIDs can alter the cardioprotective effect of what?

Answer 14

Aspirin

Question 15

Avoid NSAIDs in people what age?

Answer 15

75 and older

Question 16

Decrease in response to a drug with continued use.

Answer 16

Tolerance

Question 17

4 Types of Opioids

Answer 17

1) Naturally occurring
2) Semisynthetic
3) Synthetic
4) Endogenous opioids (endorphins)

Question 18

Opioids cause the release of this substance.

Answer 18

Histamine

Question 19

Opioids increase this.

Answer 19

Intracranial pressure

Question 20

Pnemonic for the effects of Opioids

Answer 20

Miosis (pin point pupil)
Orthostatic hypotension
Respiratory depression
Physical dependency
Histamine Release
Increased ICP
Nausea
Euphoria
Sedation

Question 21

100 times more potent than Morphine

Answer 21

Fentanyl

Question 22

Short-acting opioids

Answer 22

Codeine and Hydrocodone

Question 23

Average days of use of opioids in order to develop an addiction.

Answer 23

9 days