Analgesic Pharmacology MCQ Quiz

The statement is true because pain, swelling, redness, and warmth are indeed the four classic signs of inflammation. Pain is caused by the release of chemicals that stimulate nerve endings, swelling occurs due to increased blood flow and accumulation of fluid, redness is caused by increased blood flow and dilation of blood vessels, and warmth is a result of increased blood flow to the affected area. These signs are commonly observed in inflammatory responses in the body.

Dosing appropriately is important in successful pain management because it ensures that the patient receives the right amount of medication to effectively manage their pain without causing unnecessary side effects or risks. This approach takes into account factors such as the severity of pain, the individual's tolerance and response to medication, and any other medical conditions they may have. By tailoring the dosage to each patient's specific needs, healthcare providers can optimize pain relief while minimizing potential harm.

Aspirin should be avoided in this patient with a history of GI irritation and bleeding because it is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of gastrointestinal bleeding. NSAIDs inhibit the production of prostaglandins, which help protect the stomach lining. This can lead to irritation and ulcers in the gastrointestinal tract. Therefore, prescribing aspirin in this case may exacerbate the patient's symptoms and potentially cause further complications.

Reye's syndrome is a rare but serious condition that primarily affects children and teenagers recovering from a viral infection, such as the flu or chickenpox. It is characterized by swelling in the liver and brain, leading to symptoms such as vomiting, confusion, and seizures. The use of aspirin during or after a viral infection has been linked to an increased risk of developing Reye's syndrome. Therefore, (Acetylsalicylic acid) Aspirin is associated with Reye's syndrome.

The statement is true because C fibers are a type of nerve fibers that transmit pain signals to the brain. When there are more C fibers activated, it indicates a stronger pain stimulus, resulting in a greater sensation of pain. Therefore, an increase in the number of C fibers would lead to an increased perception of pain.

Naloxone (Narcan) and Naltrexone (Revia) are classified as opioid antagonists. Opioid antagonists are medications that bind to opioid receptors in the brain, blocking the effects of opioids. They are commonly used to reverse the effects of opioid overdose and to help individuals with opioid addiction by reducing cravings and preventing the euphoric effects of opioids. These medications work by competitively binding to the opioid receptors, effectively blocking the opioids from binding and activating the receptors. This class of drugs is essential in emergency situations and in the treatment of opioid use disorder.

Phantom pain refers to the sensation of pain in a body part that has been amputated. It is a common phenomenon experienced by individuals who have undergone amputations. The brain continues to receive signals from the nerves that used to be connected to the amputated limb, leading to the perception of pain. Therefore, previous amputation would be a plausible explanation for phantom pain.

Respiratory depression is the most significant adverse effect of opioid agonists and a hallmark of toxicity. Opioid agonists can suppress the respiratory drive in the brainstem, leading to shallow or slowed breathing. This can result in decreased oxygen levels in the blood and potentially lead to respiratory failure and death. Monitoring respiratory status is crucial when administering opioid agonists to ensure patient safety.

Diacetylmorphine, commonly known as heroin, has no recognized medical use. It is classified as an illegal drug due to its high potential for abuse and addiction. While Fentanyl and Oxycodone are both powerful opioids used for pain management, heroin is not approved for any medical purposes and is highly dangerous and illegal.

Nabumetone (Relafen) is not a COX-2 inhibitor because it is a nonsteroidal anti-inflammatory drug (NSAID) that primarily inhibits COX-1 rather than COX-2. COX-2 inhibitors specifically target the cyclooxygenase-2 enzyme, which is responsible for inflammation and pain. Rofecoxib (Vioxx), Celecoxib (Celebrex), and Valdecoxib (Bextra) are all COX-2 inhibitors commonly used to treat pain and inflammation.

Salicylate toxicity involves all of the above mentioned symptoms. Serum levels above 300ug/ml are indicative of salicylate toxicity. Metabolic acidosis occurs due to the accumulation of salicylates in the body, leading to increased production of lactic acid. Respiratory alkalosis is also observed as a compensatory mechanism to counteract the acidosis. Therefore, all of these symptoms are characteristic of salicylate toxicity.

Robitussin-AC is a commonly used cough medicine that contains codeine, an opioid that helps suppress coughing. It is often effective in treating various types of coughs, including those caused by colds, allergies, or respiratory infections. Therefore, it can be considered as a sufficient option for treating coughs in many cases.

Acetylsalicylic acid (aspirin) is a carboxylic acid because it contains a carboxyl group (-COOH) in its chemical structure. This functional group consists of a carbonyl group (C=O) and a hydroxyl group (OH) attached to the same carbon atom. Carboxylic acids are organic compounds that are characterized by their acidic properties and can be found in various substances such as vinegar and citrus fruits. Acetylsalicylic acid is commonly used as a pain reliever and anti-inflammatory medication.

An opioid agonist is a substance that activates opioid receptors in the brain. These receptors are responsible for pain relief and sedation. Therefore, it is unlikely to expect increased GI motility, pupil dilation, or arousal from an opioid agonist. Instead, opioids typically cause constipation, constricted pupils, and drowsiness. Hence, the correct answer is "None of these."

Morphine sulfate is the correct answer because it is a potent analgesic that is commonly used for pain relief. It also has anxiolytic properties, meaning it can help reduce anxiety. Additionally, morphine sulfate has the ability to cause peripheral vasodilation, which can help increase blood flow to the extremities. Hydrocodone/APAP (Vicodin) is another analgesic but does not have the same anxiolytic or vasodilation effects. Naloxone (Narcan) and naltrexone (Revia) are opioid antagonists used to reverse the effects of opioid overdose and addiction, respectively, and do not have the same analgesic or anxiolytic properties as morphine sulfate.

This statement is false because not all NSAIDs are acidic compounds. While some NSAIDs may be acidic, there are also non-acidic NSAIDs available. Therefore, it is incorrect to say that all NSAIDs are acidic compounds.

Morphine and codeine are natural opioids. Morphine is derived from the opium poppy plant and is a potent pain reliever. Codeine is also derived from the opium poppy plant and is commonly used as a cough suppressant and mild pain reliever. Oxycodone, on the other hand, is a semi-synthetic opioid and is not considered a natural opioid. Therefore, the correct answer is A & C.

The correct answer is Hydrocodone 5mg/APAP 500mg (Vicodin)1-2 TabsPO q4-6hrs. This is because Hydrocodone is the primary drug in the medication, and it is prescribed at a dose of 5mg. APAP (acetaminophen) is a secondary ingredient and is prescribed at a dose of 500mg. The dosage frequency is every 4-6 hours, and the patient is instructed to take 1-2 tablets per dose. This prescription provides the appropriate amounts of both drugs and follows the recommended dosing schedule.

All of the above options may be used to treat a recovering drug addict. Buprenorphine/Naloxone (suboxone) is a medication that helps reduce withdrawal symptoms and cravings. Naltrexone long-acting (Vivitrol) is an opioid antagonist that blocks the effects of opioids and reduces cravings. Methadone (Dolophine) is a long-acting opioid agonist that helps manage withdrawal symptoms and reduce cravings. These medications can be used in combination with counseling and behavioral therapies to support the recovery process.

The correct answer is 300 APAP/30 codeine (Tylenol #3) 1-2 tabs PO q 4-6 hrs. This is the appropriate prescription for codeine because it specifies the correct dosage of both codeine (30mg) and APAP (300mg) in each tablet. It also provides instructions for administration (1-2 tablets) and the frequency (every 4-6 hours). This prescription ensures that the patient receives the correct amount of medication at the appropriate intervals for effective pain relief.

Meperidine (Demerol) is the correct answer because it is less desirable for recreational use compared to other opioids. It has a shorter duration of action and is less potent, making it less appealing for seekers who are looking for a stronger and longer-lasting high. Administering it intramuscularly (IM) also ensures a slower onset of action compared to other routes, reducing the potential for abuse.

Piroxicam (Feldene) is actually an NSAID, so the statement that it is not an NSAID is incorrect. It is commonly prescribed alongside other NSAIDs to help protect the gastrointestinal (GI) mucosa and prevent GI bleeds, as it has a lower risk of causing GI side effects compared to some other NSAIDs. Therefore, the correct answer is False.

Hydrocodone and Oxycodone are both synthetic opioids. Hydrocodone is a semi-synthetic opioid derived from codeine, while Oxycodone is a fully synthetic opioid. Methadone, on the other hand, is a synthetic opioid that is primarily used for the treatment of opioid addiction and dependence. Therefore, the correct answer is A & C, as both Hydrocodone and Oxycodone are synthetic opioids.

Etodolac (Lodine), tolmetin (Tolectin), and Diclofenac sodium (Voltaren) belong to the class of drugs known as acetic acids. This class of drugs is commonly used as nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain, reduce inflammation, and lower fever. Acetic acids work by inhibiting the production of certain chemicals in the body that cause inflammation and pain. These drugs are commonly prescribed for conditions such as arthritis, menstrual cramps, and acute injuries.

Vivitrol is an extended-release injectable form of naltrexone, which is used to treat alcohol and opioid dependence. It works by blocking the effects of opioids in the brain. Patients who are dependent on opioids may experience withdrawal symptoms when taking Vivitrol, which can include feelings of depression, anxiety, and even suicidal thoughts. Therefore, a patient taking Vivitrol may need to be placed on suicide watch to ensure their safety. Oxycodone, Tramadol, and Clonidine do not typically have this side effect.