CHPN Pharmacology & Medication Management Flashcards

Which opioid is considered first-line for moderate-to-severe pain in hospice patients with normal renal function?

Answer: Morphine

Morphine is the gold-standard first-line opioid for moderate-to-severe pain in hospice patients with intact renal function.

A hospice patient is experiencing opioid-induced constipation. Which medication is specifically FDA-approved for this indication?

Answer: Methylnaltrexone

Methylnaltrexone (Relistor) is a peripherally acting mu-opioid receptor antagonist FDA-approved specifically for opioid-induced constipation.

When converting from oral morphine to subcutaneous morphine, what is the standard conversion ratio?

Answer: 3:1 (oral to subcutaneous)

The standard oral to subcutaneous morphine conversion is 3:1, meaning 30 mg oral morphine equals 10 mg subcutaneous morphine.

Which benzodiazepine is most commonly used in hospice care to manage refractory dyspnea and anxiety at end of life?

Answer: Lorazepam

Lorazepam is preferred in hospice for its short-to-intermediate half-life, multiple routes of administration, and efficacy for dyspnea and anxiety.

A hospice nurse notes a patient on fentanyl patches is febrile. What is the most important medication concern?

Answer: Fever increases fentanyl absorption through the patch, risking overdose

Elevated body temperature increases transdermal fentanyl absorption significantly, which can lead to opioid toxicity.

Which medication is used to reduce respiratory secretions ('death rattle') in a dying patient?

Answer: Glycopyrrolate

Glycopyrrolate is an anticholinergic agent that reduces salivary and bronchial secretions without crossing the blood-brain barrier.