MTM Pain Management & Opioid Stewardship 3

Question 1

A patient on chronic opioid therapy presents with constipation that has not responded to standard laxatives. Which agent is specifically FDA-approved for opioid-induced constipation (OIC) in non-cancer patients?

Accepted Answer

Methylnaltrexone (Relistor)

Answer

Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist (PAMORA) FDA-approved for OIC that blocks GI opioid effects without reversing central analgesia.

Question 2

Which state-level monitoring program should a pharmacist consult before dispensing a Schedule II opioid to a new patient to identify potential 'doctor shopping'?

Accepted Answer

Prescription Drug Monitoring Program (PDMP)

Answer

PDMPs are state-run electronic databases that track controlled substance prescriptions, helping pharmacists identify patients obtaining opioids from multiple prescribers.

Question 3

An MTM pharmacist identifies a patient on chronic opioids who scores 15 on the COMM (Current Opioid Misuse Measure). What does a score ≥9 on this scale indicate?

Accepted Answer

The patient is likely currently misusing opioids and warrants further evaluation

Answer

A COMM score ≥9 suggests probable current opioid misuse and should prompt the clinician to reassess the treatment plan and consider addiction specialist referral.

Question 4

Naloxone dispensed for opioid overdose reversal primarily works by which mechanism?

Accepted Answer

Competitive antagonism at mu-opioid receptors

Answer

Naloxone competitively antagonizes mu-opioid receptors, rapidly reversing opioid-induced respiratory depression, sedation, and analgesia.

Question 5

A cancer patient requires around-the-clock opioid therapy with a short-acting agent for breakthrough pain. What is the standard recommendation for breakthrough dose as a percentage of the total daily opioid dose?

Accepted Answer

10–15% of the total daily dose every 4–6 hours as needed

Answer

Breakthrough doses are typically 10–15% of the total daily opioid dose (equivalent to 1/6 of the 24-hour dose), given every 1–4 hours as needed.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Pain Management & Opioid Stewardship 3