Pain

Question 1

Which opioid has both agonist and antagonist properties

Answer 1

Buprenorphine

Question 2

True or false: Opioids can cause postural hypotension

Answer 2

TRUE

Question 3

Opioids cause bronchoconstriction by: _______

Answer 3

Opioid induced histamine release

Question 4

What effect do opioids have on the skin? (2 points)

Answer 4

Pruritis

Flushing

Question 5

True or false: Pinpoint pupils are a sign of opioid WITHDRAWAL

Answer 5

FALSE - pinpoint pupils are a side effect and potential sign of overdose
Opioid withdrawal causes pupils to dilate

Question 6

Which long acting opioids are used to aid opioid withdrawal? (2 points)

Answer 6

Buprenorphine and Methadone

Question 7

_____ is less sedating and has a longer duration of action than morphine

Answer 7

Methadone

Question 8

______ is the preferred strong opioid in renal impairment

Answer 8

Oxycodone

Morphine preferred in hepatic impairment

Question 9

Which opioid also has noradrenergic and serotonergic activity

Answer 9

Tramadol

Question 10

First line for neuropathic pain? (3 options)

Answer 10

Amitriptyline
Duloxetine
Gabapentinoids (gabapentin and pregabalin)

Question 11

Which drug is licensed for trigeminal neuralgia?

Answer 11

Carbamazepine

Question 12

True or false: Paracetamol alone is ineffective for managing low back pain

Answer 12

TRUE

Use alongside NSAIDs (or weak opioids if CI)

Question 13

______ offered first line for low back pain if non-drug treatment has failed

Answer 13

NSAIDs

Question 14

Maximum dose of tramadol in 24 hours

Answer 14

400mg (4 capsules of 100mg)

Question 15

True or false: Triptans are contraindicated in ischaemic heart disease (IHD)

Answer 15

TRUE

They are contraindicated in ischaemic heart diseases including TIA

Question 16

What is the maximum daily dose of sumatriptan

Answer 16

300 mg

6 x 50mg tablets

Question 17

If migraine symptoms come back, after how long can another sumatriptan dose be taken ?

Answer 17

After 2 hours

Max. 300mg in 24 hours

Question 18

Nefopam colours the urine.

What colour

Answer 18

Pink

Question 19

In which circumstances might a patient be considered for prophylactic migraine treatment

(4 points)

Answer 19

At least 2 attacks per month

Increased frequency of headaches

Significant disability despite suitable treatment

Not taking suitable treatment

Question 20

Which opioid’s effects are only partially reversed by naloxone

Answer 20

Buprenorphine ( as it is only a partial agonist - has agonist and antagonist properties)

Question 21

Pizotifen is a drug that can be used for prevention of cluster headache and migraine (not used often)
What are the common side effects?

(6 points)

Answer 21

Appetite increased
Weight gain
Dry mouth
Dizziness 
Nausea 
Fatigue/drowsiness