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Pain Management & Opioid Stewardship Flashcards

7 cards from real MTM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Pain Management & Opioid Stewardship flashcards as text

  1. A patient on long-term opioid therapy reports their pain is well-controlled but expresses concern about dependence. Which statement best distinguishes physical dependence from addiction?

    Answer: Physical dependence means the body adapts to the drug and withdrawal occurs if stopped abruptly, while addiction involves compulsive use despite harm

    Physical dependence is a physiological adaptation where abrupt discontinuation causes withdrawal, whereas addiction is a behavioral disorder characterized by compulsive use despite adverse consequences.

  2. Which opioid analgesic has the longest half-life and poses the greatest risk of accumulation in elderly patients?

    Answer: Methadone

    Methadone has an unpredictable and prolonged half-life (8–59 hours), making it prone to accumulation and delayed toxicity, especially in elderly patients.

  3. Under the CDC Opioid Prescribing Guidelines, what is the recommended maximum daily morphine milligram equivalent (MME) threshold that should prompt clinician reassessment of risks?

    Answer: 90 MME/day

    The CDC guideline recommends reassessing risks and benefits when doses reach or exceed 90 MME/day, as overdose risk increases significantly at this threshold.

  4. A pharmacist performs MTM for a patient taking oxycodone and alprazolam. What is the primary concern with this combination?

    Answer: Synergistic CNS and respiratory depression increasing overdose risk

    Concurrent opioid and benzodiazepine use causes additive CNS and respiratory depression, substantially increasing the risk of fatal overdose.

  5. Which tool is most appropriate for an MTM pharmacist to use when screening a patient for opioid misuse risk before initiating long-term opioid therapy?

    Answer: ORT (Opioid Risk Tool)

    The Opioid Risk Tool (ORT) is a validated 5-item screening tool used to stratify patients into low, moderate, or high risk for opioid aberrant behaviors.

  6. A patient is being transitioned from IV morphine to oral oxycodone. Using equianalgesic dosing, how does 10 mg IV morphine compare to oral oxycodone?

    Answer: 10 mg IV morphine ≈ 15 mg oral oxycodone

    10 mg IV morphine is approximately equianalgesic to 20–30 mg oral morphine, and oral oxycodone is roughly 1.5 times as potent as oral morphine, yielding approximately 15 mg oral oxycodone.

  7. Which non-pharmacological intervention has the strongest evidence for chronic low back pain management as a first-line approach before initiating opioids?

    Answer: Cognitive behavioral therapy and exercise

    Cognitive behavioral therapy combined with exercise has the strongest evidence base for chronic low back pain and is recommended as first-line non-pharmacological treatment by multiple guidelines.