Opioid and non-opioid analgesics 5

Question 1

Why might nalmefene be used?

Answer 1

to maintain recovering opioid abusers

Question 2

Nalmefene has a profile similar to

Answer 2

naloxone however its duration of action is much longer- about 10 hours

Question 3

Naltrexone does not

Answer 3

undergo significant first-pass metabolism

Question 4

Naltrexone can be given

Answer 4

orally

Question 5

Naltrexone has a duration of action of

Answer 5

up to 24 hours

Question 6

Naltrexone can be used for

Answer 6

an extended-release may be used for alcohol withdrawal treatment
maintain recovering opioid abusers

Question 7

The “gold standard” method of postoperative opioid delivery is

Answer 7

IV PCA

Question 8

Benefits of IV PCA include

Answer 8

better postop analgesia and improved patient satisfaction

Question 9

Factors that increase the risk of respiratory depression with IV PCA include

Answer 9

basal infusion rate (background infusion)
administration of other sedative medications
old age
pulmonary disease
obstructive sleep apnea

Question 10

The programmable components of IV PCA include

Answer 10

initial loading dose
demand dose
lockout interval
basal infusion rate

Question 11

The lockout interval is based on

Answer 11

the time it takes for the demand dose to reach an effective plasma concentration

Question 12

The use of a basal rate does not provide

Answer 12

superior pain relief or improved sleep but it does increase the risk of respiratory depression

Question 13

A multimodal approach to analgesia should be considered for patients with

Answer 13

OSA
advanced age
opioid dependence

Question 14

The first dose required to achieve a given plasma concentration:

Answer 14

initial loading dose

Question 15

The dose delivered when the patient pushes the PCA button

Answer 15

demand dose

Question 16

The amount of time that must elapse between demand doses

Answer 16

lockout interval

Question 17

Continuous rate of a background infusion

Answer 17

basal infusion rate

Question 18

_________—reduce IV PCA opioid requirements

Answer 18

Scheduled NSAIDs

Question 19

To reduce the risk of respiratory depression and cardiac arrest, patients receiving IV PCA should be

Answer 19

monitored (either in the ICU or a unit with intermittent monitoring protocols)
-monitoring EtCo2 is a more sensitive measure of respiratory depression compared to RR

Question 20

____________ may produce less N/V, pruritus, and urinary retention than morphine or hydromorphone when used for IV PCA

Answer 20

Fentanyl

Question 21

___________ is useful for patients who only experience short bursts of pain (e.g. labor)

Answer 21

Remifentanil