Narcotic analgesics

Question 1

opiate definition + examples

Answer 1

natural –> morphine, codiene

Question 2

opioid definition

Answer 2

synthetic/semi-synthetic

Question 3

narcotic drug used as prototype for dose conversions

Answer 3

morphine

Question 4

most potent to least potent narcotic analgesics

Answer 4

fentanyl > hydromorphone, cod- > morphine > metripidine

Question 5

narcotic antagonist names

Answer 5

naloxone, naltroxene, naloxegel

Question 6

naloxone uses + ROA

Answer 6

reverses effects of severe opioid toxicity, not PO

Question 7

naltroxene uses

Answer 7

treatment of alcohol withdrawal + opioid use disorder

Question 8

naloxegel uses

Answer 8

opioid induced constipation

Question 9

PDMPs function

Answer 9

track every CDS prescription dispensed by any outpatient pharmacy, required in all states

Question 10

how often do pharmacists update NJ-PDMP?

Answer 10

biweekly

Question 11

REMS focuses on what kinds of opioids?

Answer 11

ER

Question 12

DEA function

Answer 12

oversee all CDS, enforced controlled substance laws

Question 13

prescription blank narcotic rules

Answer 13

includes DEA + NPI# of prescriber + serial # of blank, limited to 1 CDS per script

Question 14

telephone/e-script narcotic rules

Answer 14

no telephone orders, e-scripts allowed

Question 15

post-dated CIIs common if >__ day narcotic supply

Answer 15

30

Question 16

narcotic limit rules

Answer 16

30 days from DOI for Rx to be valid
max. 4x a day for 30 days (120 units)

Question 17

narcotic refill rules

Answer 17

CII: no refills
CIII-CV: 5 refills within 6 months of DOI

Question 18

narcotic partial filling rules

Answer 18

remainder of Rx must be filled within 72 hrs

Question 19

CDS prescription label requirements

Answer 19

DOI
patient name + address
MD name + address + DEA #
drug name, strength, dosage form
quantity prescribed
# of refills
prescriber signature

Question 20

CDS labeling requirements

Answer 20

pharmacy name + address
Rx serial #
date of fill + DOI
patient name
MD name
directions of use
refill info
cautionary label

Question 21

narcotic analgesic names

Answer 21

-orph-, -cod-, -fent-, -adol, -nal, meperidine, methadone

Question 22

narcotic analgesic MOA

Answer 22

narcotic agonist

Question 23

narcotic analgesic effects

Answer 23

analgesic, euphoria/dysphoria, respiratory depression, dependence, sedation, miosis, decreased GI motility

Question 24

narcotic analgesic indications

Answer 24

acute pain (IR), chronic pain (ER)

Question 25

narcotic analgesic BBW

Answer 25

hypoventilation, abuse/addiction, not for children, ER formulations, abrupt treatment effects, chronic pregnancy use, avoid splitting

Question 26

narcotic analgesic DDI

Answer 26

benzodiazepines, alcohol, barbiturates, MAOIs –> increased respiratory depression
enzyme inducer/inhibitor (clarithromycin, ketoconazole, linezoid, diltiazem, verapamil)

Question 27

narcotic analgesic ADEs

Answer 27

pregnancy category C, somnolence

Question 28

narcotic analgesic contraindications

Answer 28

respiratory depression, bronchial asthma, convulsive disorders, addiction-prone, treatment of diarrhea