DPT DPT Pharmacology & Pain Management 2

Question 1

Gabapentin is frequently prescribed for neuropathic pain. What is its primary mechanism of action?

Accepted Answer

Binds to voltage-gated calcium channels reducing excitatory neurotransmitter release

Answer

Gabapentin binds to the alpha-2-delta subunit of voltage-gated calcium channels, reducing release of excitatory neurotransmitters in the dorsal horn.

Question 2

A patient using topical diclofenac gel reports decreased pain at the knee. What is the primary advantage of topical over oral NSAIDs?

Accepted Answer

Reduced systemic GI and renal side effects

Answer

Topical NSAIDs achieve local tissue concentrations with minimal systemic absorption, greatly reducing GI and renal adverse effects.

Question 3

Which measurement tool best captures a patient's self-reported pain intensity in a standardized, reproducible way during PT reassessment?

Accepted Answer

Numeric Pain Rating Scale (NPRS)

Answer

The NPRS (0–10) is widely validated, quick to administer, and sensitive to change for tracking pain intensity across PT sessions.

Question 4

Serotonin-norepinephrine reuptake inhibitors (SNRIs) like duloxetine are used for chronic musculoskeletal pain primarily because they:

Accepted Answer

Modulate descending pain inhibitory pathways

Answer

SNRIs enhance descending noradrenergic and serotonergic inhibition of pain transmission from the brainstem to the spinal dorsal horn.

Question 5

A patient taking bisphosphonates for osteoporosis is beginning a resistance exercise program. What is the most important precaution?

Accepted Answer

Screen for atypical femoral fractures before high-impact loading

Answer

Long-term bisphosphonate use is associated with atypical femoral fractures, requiring screening before initiating high-impact or resistance loading.

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