Opioids

Choose the ONE best answer.


1. A young woman is brought into the emergency room. She is unconscious, and she has pupillary constriction and depressed respiration. Based on reports, an opioid overdose is almost certain. Which of the listed phenanthrene opioids will exhibit a full and immediate response to treatment with naloxone?


A. Morphine.

B. Meperidine.

C. Buprenorphine.

D. Fentanyl.


2. A 76-year-old female with renal insufficiency presents to the clinic with severe pain secondary to a compression fracture in the lumbar spine. She reports that the pain has been uncontrolled with tramadol, and it is decided to start treatment with an opioid. Which of the following is the best opioid for this patient?


A. Meperidine.

B. Morphine.

C. Hydrocodone.

D. Fentanyl transdermal patch.


3. Which of the following statements about fentanyl is correct?


A. Fentanyl is 100 times more potent than morphine.

B. Its withdrawal symptoms can be relieved by naloxone.

C. The active metabolites of fentanyl can cause seizures.

D. It is most effective by oral administration.


4. A 56-year-old patient who has suffered with severe chronic pain with radiculopathy secondary to spinal stenosis for years presents to the clinic for pain management. Over the years, this patient has failed to receive relief from the neuropathic pain from the radiculopathy with traditional agents such as tricyclics or anticonvulsants. Based on the mechanism of action, which opioid might be beneficial in this patient to treat both nociceptive and neuropathic pain?


A. Methadone.

B. Oxymorphone.

C. Morphine.

D. Meperidine.


5. Which of the following statements regarding methadone is correct?


A. Methadone is an excellent choice for analgesia in most patients since there are limited drug–drug interactions.

B. The equianalgesic potency of methadone is similar to that of morphine.

C. The active metabolites of methadone accumulate in patients with renal dysfunction.

D. The duration of analgesia for methadone is much shorter than the elimination half-life.


6. Which of the following opioids is the LEAST lipophilic?


A. Fentanyl.

B. Methadone.

C. Morphine.

D. Meperidine.


7. A 64-year-old male is preparing for a total knee replacement. He is taking many medications that are metabolized by the CYP450 enzyme system and is worried about drug interactions with the pain medication that will be used following his surgery. Which of the following opioids would have the lowest chance of interacting with his medications that are metabolized by the CYP450 enzyme system?


A. Methadone.

B. Oxycodone.

C. Oxymorphone.

D. Hydrocodone.


8. Which of the following opioids is the best choice for treating pain associated with diabetic peripheral neuropathy?


A. Morphine.

B. Tapentadol.

C. Codeine.

D. Buprenorphine.



9. KM is a 64-year-old male who has been hospitalized following a car accident in which he sustained a broken leg and broken arm. He has been converted to oral morphine in anticipation of his discharge. What other medication should he receive with his morphine upon discharge?


A. Diphenhydramine.

B. Docusate sodium with senna.

C. Methylphenidate.

D. Docusate sodium.


10. AN is a 57-year-old male who has been treated with oxycodone for chronic nonmalignant pain for over 2 years. He is now reporting increased pain in the afternoon while at work. Which of the following opioids is a short-acting opioid and is the best choice for this patient’s breakthrough pain?


A. Methadone.

B. Pentazocine.

C.. Nalbuphine.

D. Hydrocodone