CCAT Pain Management and Pharmacology 2 — Questions and Answers
Question 1: Which opioid receptor subtype is primarily responsible for spinal analgesia in companion animals?
- Mu (μ) (Correct answer)
- Kappa (κ)
- Delta (δ)
- Sigma (σ)
Correct answer: Mu (μ)
Mu opioid receptors are the primary mediators of spinal analgesia and are the main target of most clinically used opioids.
Question 2: A dog recovering from orthopedic surgery shows signs of wind-up pain. Which pharmacological class best addresses central sensitization?
- NSAIDs
- NMDA receptor antagonists (Correct answer)
- Mu opioid agonists
- Alpha-2 agonists
Correct answer: NMDA receptor antagonists
NMDA receptor antagonists like ketamine directly block the glutamate receptors responsible for central sensitization and wind-up pain.
Question 3: Gabapentin is classified pharmacologically as:
- An NSAID with COX-2 selectivity
- An alpha-2-delta calcium channel ligand (Correct answer)
- A sodium channel blocker
- A serotonin-norepinephrine reuptake inhibitor
Correct answer: An alpha-2-delta calcium channel ligand
Gabapentin binds to the alpha-2-delta subunit of voltage-gated calcium channels, reducing excitatory neurotransmitter release.
Question 4: Which route of tramadol administration in cats is LEAST effective due to poor oral bioavailability of the active metabolite O-desmethyltramadol?
- Intravenous
- Oral (Correct answer)
- Subcutaneous
- Transmucosal
Correct answer: Oral
Cats have limited ability to convert tramadol to its active metabolite O-desmethyltramadol via CYP2D6, making oral dosing less effective than parenteral routes.
Question 5: During rehabilitation, a therapist notices a patient is on long-term corticosteroids. Which concurrent medication is CONTRAINDICATED due to high risk of gastrointestinal ulceration?
- Gabapentin
- Amantadine
- Meloxicam (Correct answer)
- Tramadol
Correct answer: Meloxicam
Combining corticosteroids with NSAIDs like meloxicam dramatically increases the risk of GI ulceration and hemorrhage.
Question 6: The Numeric Rating Scale (NRS) for pain in animals differs from the Visual Analog Scale (VAS) in that it:
- Uses descriptive words instead of numbers
- Uses discrete numbered categories instead of a continuous line (Correct answer)
- Requires the animal's owner to score only
- Is only validated for cats, not dogs
Correct answer: Uses discrete numbered categories instead of a continuous line
The NRS uses discrete integer categories (e.g., 0–10) while the VAS uses a continuous 100mm line for scoring pain.
Question 7: Which pharmacokinetic parameter best describes how quickly a drug's plasma concentration declines after distribution, relevant for scheduling repeat analgesic doses?
- Volume of distribution (Vd)
- Elimination half-life (t½) (Correct answer)
- Bioavailability (F)
- Peak plasma concentration (Cmax)
Correct answer: Elimination half-life (t½)
Elimination half-life determines how long a drug remains effective and guides dosing intervals to maintain therapeutic concentrations.
CCAT Pain Management and Pharmacology 2
Which opioid receptor subtype is primarily responsible for spinal analgesia in companion animals?