1. Rapid implementation of creative prevention programs has reduced the number of fatal opioid drug poisonings in recent years.
A. True
B. False
2. Pharmacists can play an essential role in each of the Substance Abuse and Mental Health Services Administration's five strategies to prevent overdose deaths.
A. True
B. False
3. Which year had the highest recorded numbers fatal opioid poisonings?
A. 1967
B. 1999
C. 2009
D. 2014
4. Which of the following scenarios could increase overdose risk:
A. Dispensing high dose opioids (more than 50 morphine milligram equivalent)
B. Rotating from one opioid to another because of incomplete cross-tolerance
C. Concomitant opioid?alcohol use
D. Additional prescriptions for benzodiazepines and other CNS depressants
E. Previous experience with overdose
F. All of the above
5. People who have no opioid tolerance also have very low overdose risk if nonmedical use is intermittent.
A. True
B. False
6. Of the more than 26,000 opioid overdose rescues by laypeople using naloxone reported since 1996, how many were performed by active drug users?
A. None
B. A few
C. About half
D. Most
7. Why are the rare serious adverse events such as seizures, arrhythmia, and hypertensive reactions difficult to interpret?
A. Opioid toxicity and hypoxemia can manifest the same symptoms.
B. Simultaneous use of stimulants such as cocaine or amphetamines predisposes victims to hypertension once the opioid toxicity was reversed.
C. Both of the above
D. None of the above
8. Naloxone is associated with _______ risks for adverse events than other commonly used injectable rescue medications such as epinephrine for anaphylactic shock and glucagon for hypoglycemia.
A. Fewer
B. About the same
C. More
9. Providing education and take-home naloxone to laypeople should focus exclusively on the patient who may be at risk for an opioid overdose.
A. True
B. False
10. The overdose victim may feel withdrawal symptoms and/or the pain that the opioids were prescribed to treat after receiving naloxone. An overdose responder should do what to make the person feel better?
A. Encourage the victim to consume a small amount of opioids.
B. Deliver an additional dose of naloxone.
C. Tell the person that they will feel better soon, after the naloxone wears off.
D. Deliver a dose of buprenorphine to start medication-assisted therapy.
11. Which resuscitative measure is appropriate for laypeople to perform during an opioid overdose emergency?
A. Rescue breathing
B. Chest compressions
C. Both of the above
D. None of the above
12. Why should the overdose responder stay with the victim for several hours or until emergency medical providers assume care?
A. The overdose victim may feel withdrawal symptoms and/or pain and attempt to consume more opioids.
B. The overdose could recur after the naloxone wears off.
C. The victim should be civilly committed to evaluate whether there is a harm to self, and the overdose responder is often needed for that process.
D. A & B
E. B & C
F. All of the above
13. What is the minimum number of doses that should be dispensed as part of a naloxone kit?
A. 1
B. 2
C. 3
D. 4
14. Of the existing naloxone products in the United States, how many are not advised for layperson take-home naloxone use?
A. 2
B. 3
C. 5
D. All are acceptable for layperson use
15. Which of the available naloxone products allow for the user to titrate the dose?
A. Injectable (also off label nasal) generic
B. Intranasal brand name
C. Injectable generic
D. Auto-injector brand name
E. A & B
F. A & C
16. Which of the available naloxone products must be manually compounded to create a complete naloxone kit?
A. Injectable (and nasal) generic
B. Intranasal brand name
C. Injectable generic
D. Auto-injector brand name
E. A & B
F. A & C
17. Which mechanisms may pharmacists use to expand naloxone access?
A. Collaborative pharmacy practice agreements
B. Standing orders for naloxone provision by pharmacists
C. Naloxone provision per licensing pharmacy or medicine board protocol
D. Pharmacist as prescriber
E. All of the above
18. Which of the above mechanisms is least likely to require policy or legislative adjustments?
A. Collaborative pharmacy practice agreements
B. Designate naloxone over the counter
C. Standing orders for naloxone provision by pharmacists
D. Naloxone provision per licensing pharmacy or medicine board protocol
E. Pharmacist as prescriber
19. Which of the four pharmacy-based naloxone models has the most limited geographical reach?
A. Collaborative pharmacy practice agreements
B. Standing orders for naloxone provision by pharmacists
C. Naloxone provision per licensing board protocol
D. Pharmacist as prescriber
20. By September 2015, all but ________ states had passed legislation to improve layperson naloxone access.
A. 2
B. 5
C. 7
D. 13
