Exam 13: Drugs for the Control of Pain and Fever

Pure opioids such as morphine activate these receptors in order to lessen pain. (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Ms. Coidiuf, age 42, sustained a back injury three years ago, which responded well to treatment with nonsteroidal anti-inflammatory medication. Over the last six months, Ms. Coidiuf has been seeing her physician again with complaints of painful sensations "shooting" down her right hip. Despite careful attention, it appears that Ms. Coidiuf's pain is no longer responding to anti-inflammatory medication. Her physician prescribes a narcotic analgesic (moderate effectiveness) with acetaminophen, hoping this treatment might provide relief. Following three physical therapy sessions, the patient continues to report that she is "still miserable," leading her physician to believe that her condition is worsening. Heat packs, massage, and relaxation therapy have not been successful. -What was the most likely target of pharmacological intervention for Ms. Coidiuf three years ago?

When used together with medication, non-pharmacological techniques often allow for lowering of medication doses.

Ms. Coidiuf, age 42, sustained a back injury three years ago, which responded well to treatment with nonsteroidal anti-inflammatory medication. Over the last six months, Ms. Coidiuf has been seeing her physician again with complaints of painful sensations "shooting" down her right hip. Despite careful attention, it appears that Ms. Coidiuf's pain is no longer responding to anti-inflammatory medication. Her physician prescribes a narcotic analgesic (moderate effectiveness) with acetaminophen, hoping this treatment might provide relief. Following three physical therapy sessions, the patient continues to report that she is "still miserable," leading her physician to believe that her condition is worsening. Heat packs, massage, and relaxation therapy have not been successful. -Which narcotic analgesics was probably given to Ms. Coidiuf?

The pharmacist is caring for a patient who has a morphine PCA. Which medication should the pharmacist ensure is readily available?

The following substance is important for controlling whether pain signals continue to the brain.

Opioids interact with at least six types of receptors: mu (types one and two), kappa, sigma, delta, and epsilon but from the perspective of pain management, the mu and delta receptors are the most important.

Alternatives or adjuncts to pharmacological therapies for pain would include: (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Ms. Coidiuf, age 42, sustained a back injury three years ago, which responded well to treatment with nonsteroidal anti-inflammatory medication. Over the last six months, Ms. Coidiuf has been seeing her physician again with complaints of painful sensations "shooting" down her right hip. Despite careful attention, it appears that Ms. Coidiuf's pain is no longer responding to anti-inflammatory medication. Her physician prescribes a narcotic analgesic (moderate effectiveness) with acetaminophen, hoping this treatment might provide relief. Following three physical therapy sessions, the patient continues to report that she is "still miserable," leading her physician to believe that her condition is worsening. Heat packs, massage, and relaxation therapy have not been successful. -Which symptom has Ms. Coidiuf likely avoided by her physician switching to narcotic therapy?

The chemical mediators of inflammation are released from the mast cell when it ruptures as part of the inflammatory response.

Spinal substance P is critical because it controls whether pain signals will continue to the brain.

A fever results when the pituitary becomes reset to maintain the body at a new temperature that is higher than the normal temperature of 37°C.

A patient is on fentanyl patches for your chronic pain. The patient gives old patches to a friend to discard. The next day, the friend is found dead after smoking the fentanyl patch. Why did this result in death? How could this have been prevented?

Which statements are true regarding pain medications? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

A patient is being discharged with a prescription for oxycodone HCl. Which discharge instructions are appropriate? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.

One method of treating opioid dependence has been to switch the patient from intravenous and inhalation forms of illegal drugs to injectable methadone.

Butorphanol is an example of a pure opioid antagonist used to reverse the effects of opioid overdose.

An NSAID, such as acetaminophen, would prevent the inflammatory response by preventing the formation of prostaglandins.

Typical signs and symptoms of inflammation is dehydration and paleness of skin.

The pharmacist is caring for an adult patient with a fever. Which medications are appropriate for the patient to take? (Select all that apply.) Note: Credit will be given only if all correct choices and no incorrect choices are selected.