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1. A patient presents to the family medicine clinic reporting a history of prescription drug use and heroin abuse. He describes use of “hillbilly heroin” and occasionally “china white.” Hillbilly heroin is a common street name for what prescription medication:

A. Codeine B. Hydromorphine C. Quetiapine D. Oxycodone

2. Activation of mu-opioid receptors by opioid agonists such as heroin triggers the release of what neurochemical that promotes feelings of reward and pleasure:

A. Norepinephrine B. Dopamine C. Serotonin D. Glutamate

3. JJ is a 35 year-old man presents to the emergency department reporting severe nausea, vomiting, and diarrhea. He is yawning incessantly and complaining of severe muscleache. Upon physical examination, you note that his pupils are dilated. This patient is displaying signs and symptoms consistent with opioid:

A. Intoxication B. Withdrawal C. Overdose D. Pain syndrome

4. A 40 year-old woman presents with a new prescription for oxycodone ER 40 mg daily for chronic back pain. In the medication profile, you note that she has also been prescribed quetiapine 600 mg at bedtime, cyclobenzaprine 10 mg daily, tramadol 50 mg twice daily, diazepam 40 mg twice daily, and oxycodone 5 mg four times daily. This patient is at a higher risk for an overdose due to her:

A. Age B. Female gender C. Multiple CNS depressant use D. Chronic back pain condition

5. A local pharmacist requests further information on naloxone rescue treatment for patients and prescribers in the community. What online resource provides training videos and education pamphlets on naloxone use:

A. Prescribe to Prevent B. State boards of pharmacy C. University counseling centers D. American Red Cross

6. Prescription drug monitoring programs are state-specific databases allowing pharmacists and other health professionals to track controlled substance prescribing and dispensing. The CDC recommends that providers use this resource to:

A. Increase local prescription drug abuse arrests B. Report drug misuse to the DEA C. Make safe and effective treatment decisions D. Prevent prescription drug trafficking

7. Pharmacists can play an active role in prescription drug disposal, in an effort to reduce the illegal exchange and sale of expired controlled substances. Which of the following organizations or agencies is responsible for hosting local drug take-back events:

A. Board of pharmacy B. DEA C. Community pharmacists D. Law enforcement organizations

8. Patients and their loved ones should be educated on the differing signs and symptoms of opioid intoxication and overdose. Symptoms consistent with opioid overdose would include:

A. Insomnia and irritability B. Respiratory rate of 20 inhalations per minute C. Lethargic, unable to talk D. Mydriasis and rhinorrhea

9. The pharmacist is providing education to a patient and family member on the use of naloxone rescue therapy. The family member asks for further information on the differing delivery systems and administration techniques. What educational statement is correct to provide:

A. Naloxone is available as an inhaler, nasal spray, and injection B. Naloxone injection is administered into the chest to directly reach the heart C. A second dose of naloxone injection can be administered in 2 to 3 minutes D. Naloxone injections are not covered by prescription insurance plans

10. Naloxone rescue therapy can be offered to any individual who is exposed to opioids. Which of the following patients would be considered at higher risk and should be offered naloxone:

A. A patient taking benzodiazepines only B. A patient taking oxycodone 80 mg daily C. All teenagers in urban high schools D. History of cocaine abuse and in recovery