Deck 19: Analgesics, Sedatives, and Hypnotics

Question 1

Lyndon usually avoids the use of benzodiazepines but his insomnia is playing havoc with his life.His doctor prescribes a melatonin receptor agonist.How should Lyndon take this medication?

A)on an empty stomach within 15 minutes of going to bed
B)within 30 minutes of going to bed with a high fat meal or snack
C)an hour before going to bed,with at least 16 ounces of water
D)within 30 minutes of going to bed with a high protein meal or snack

Answer 1

within 30 minutes of going to bed with a high fat meal or snack

Question 2

Hasan has long QT syndrome and experiences episodes of rapid,chaotic heart beats.He is having surgery and discusses pain control with his surgeon.Which analgesic is itself associated with sometimes fatal QT prolongation and should therefore be avoided?

A)tramadol
B)meperidine
C)naltrexone
D)methadone

Answer 2

methadone

Question 3

Your 73-year-old grandmother,who rarely drinks alcohol and has no history of drug abuse,is reluctant to take opioid analgesics following her hip surgery.Should she be concerned about addiction?

A)No.Older people do not usually become addicted to medication.
B)Absolutely.Anyone can become addicted very quickly,even with no previous history.
C)Not at her age.It doesn't really matter even if she does become addicted.
D)Probably not.The majority of people stop taking opioids when their pain stops

Answer 3

Probably not.The majority of people stop taking opioids when their pain stops

Question 4

Thaddeus has shooting,shock-like pain from shingles (herpes zoster).What Schedule V second-generation anticonvulsant might be used as an adjuvant?

A)carbamazepine
B)lamotrigine
C)gabapentin
D)pregabalin

Question 5

Levi wonders why acetaminophen is used so frequently if it has little anti-inflammatory effect.Why is this?

A)It has fewer adverse effects than the salicylates.
B)It is less expensive than other NSAIDs.
C)It is more likely to produce a slight sedative effect.
D)It is a newer drug and hence regarded as "better."

Question 6

Chiara has poorly controlled pain from diabetic neuropathy.What serotonin norepinephrine reuptake inhibitor might be given as an adjuvant?

A)nortriptyline
B)carbamazepine
C)duloxetine
D)pregabalin

Question 7

After hearing about another opioid-associated overdose death,your friend wonders why nothing is being done about this issue.You can inform your friend about the market withdrawal of propoxyphene due to its association with overdose deaths and .

A)nephrotoxicity
B)birth defects
C)cardiac abnormalities
D)hepatotoxicity

Question 8

Maggie,aged 77,occasionally takes diphenhydramine to help her sleep.Is there any reason for concern?

A)Yes.Because of her age,she is much more likely to have a hypertensive crisis.
B)Yes.Because of her age,she may be more prone to side effects like confusion.
C)No.This medication is considered safe for people of any age.
D)Probably not,but she should be monitored for indications of addiction.

Question 9

Felicity has poorly controlled migraines and the resulting pain is not responsive to standard analgesic protocols.Her physician suggests the use of sumatriptan when she has an acute migraine.What is the mechanism of action for this drug?

A)selective serotonin reuptake inhibitor
B)serotonin norepinephrine reuptake inhibitor
C)seroronin receptor agonist
D)norepinephrine agonist

Question 10

Vonda is concerned about the safety of over-the-counter medications for children.She knows that one particular drug has been associated with liver toxicity and that the manufacturers of this drug have voluntarily reduced the concentration used in children's formulations.What is this drug?

A)naproxen
B)ibuprofen
C)acetaminophen
D)aspirin

Question 11

Cody openly and honestly discusses his history of addiction with his surgeon prior to surgery and asks what pain medications will have less potential for abuse.What centrally acting synthetic analog of codeine might the surgeon select?

A)tramadol
B)meperidine
C)naltrexone
D)hydrocodone

Question 12

Sybil has been taking high doses of aspirin for arthritis,and is having increasingly serious adverse effects.What medication might her health care provider suggest that has analgesic effects but very limited anti-inflammatory effects and would also allow a reduction of the aspirin dose?

A)ibuprofen
B)acetaminophen
C)naproxen
D)nabumetone

Question 13

Darlene's breast cancer has spread to her bones,causing terrible,unrelenting pain.She meets with the palliative care team to discuss pain control during the last weeks of her life,and is concerned because she has heard that doctors often withhold adequate doses of pain medication for fear of dependence or abuse.What is their philosophy likely to be?

A)Pain medication should be geared to her emotional state and limited if she is depressed or in danger of overdosing.
B)Dependence is irrelevant for dying patients and should not be a consideration.
C)Medication should be sufficient for adequate pain control but not enough to impair her consciousness.
D)Medication should be regularly administered by home health nurses,two to three times a day.

Question 14

Zara has a morphine pump to help post-surgical control pain.What side effect occurs in more than 50% of patients on morphine and often requires treatment?

A)constipation
B)dependence
C)nausea
D)seizures

Question 15

Casey recalls that her grandfather used a barbiturate to help him sleep.She asks her doctor about the use of barbiturates for insomnia and is told that they are rarely used for that purpose due to their side effects.What side- effect is of particular concern?

A)reproductive abnormalities
B)hypertension
C)CNS depression
D)GI bleeding

Question 16

John wakes up in a hospital to find that he had been in an accident that required major surgery to pin his legs back together.He is told that he has a patient controlled analgesia pump with morphine,which he recognizes as a pure opiate agonist.Is he likely to be able to achieve good pain control?

A)Possibly,but only if the surgeon also gave him a nerve block.
B)Probably not,unless that he also has PRN pain medications.
C)No.Morphine is not that effective for pain control.
D)Yes.Morphine does not have a ceiling to its analgesic effects.

Question 17

A celebrity with no history of substance abuse or bizarre behavior is found driving in circles around a fountain at three o'clock in the morning.His publicist releases a statement attributing the behavior to a prescription benzodiazepine sleep medication.Is this plausible?

A)Yes,but only if taken at well above the prescribed dose.
B)Yes,but only when combined with alcohol or other CNS depressants.
C)Yes.Use of these medications has been associated with the occurrence of complex behaviors while asleep.
D)No.This is likely a rationalization.

Question 18

Collin was given an opioid analgesic to help control the pain from a broken nose,broken teeth,and facial lacerations he suffered in a fall.He soon becomes disoriented and violently sick to his stomach.What drug might he be given to reverse the effects of the opioid?

A)naltrexone
B)carbamazepine
C)naloxone
D)meperidine

Question 19

Landen has peripheral neuropathy from cancer chemotherapy.After his pain is not well controlled with just analgesics,his physician suggests the use of a tricyclic antidepressant as an adjuvant.What drug might he be given?

A)gabapentin
B)amitriptyline
C)carbamazepine
D)venlafaxine

Question 20

Lizzy has severe chronic pain following an automobile accident and her pain specialist gives her a coanalgesic to help control her pain.What class of drugs is often used as coanalgesics?

A)NSAIDs
B)synthetic opioids
C)naltrexone analogs
D)opioid antagonists

Question 21

Ashley has insomnia and her doctor gives her medication to produce sleep.This type of medication is called a(n) ____.

A)anesthetic
B)analgesic
C)hypnotic
D)sedative

Question 22

Stan expresses his anxiety about his upcoming surgery at his pre-operative appointment.His doctor tells him that he will be given medication to calm him prior to the surgery.This type of medication is called a(n) .

A)analgesic
B)anesthetic
C)sedative
D)hypnotic

Question 23

Arleen is being treated for chronic pain and finds that she is needing higher doses of the pain medication to control her pain.This phenomenon is known as .

A)withdrawal
B)tolerance
C)addiction
D)abuse

Question 24

Nathan loves running long distances and often describes his runner's high.The phenomenon of runner's high is associated with the body's production of .

A)endorphins
B)androgens
C)catecholamines
D)histamines

Question 25

Rachel is being treated for opioid addiction with a medication that combines both a pure opioid agonist and a partial opioid agonist.What is it?

A)Suboxone
B)Narcan
C)ReVia
D)Stadol