View Exam | PowerPak

1. Opioids induce constipation primarily through gastrointestinal stimulation of what receptor?

A. Delta-opioid receptor B. Kappa-opioid receptor C. Mu-opioid receptor D. Opioid receptor-like 1

2. A patient has been taking sustained-release morphine 15 mg orally 3 times daily for 2 months for chronic back pain. She completes the Bowel Function Index (BFI) and reports her scores as follows: ease of defecation, 44 out of 100 points; feeling of incomplete bowel evacuation, 30 out of 100 points; and an overall judgment of constipation, 52 out of 100 points. Her average score is 43 out of 100 points. Which of the following statements is correct regarding this patient's presentation?

A. This patient is experiencing opioid-induced constipation (OIC) because her average score is above 28.8 points B. An improvement of 3 points in her score would signify a clinically meaningful difference in her symptoms C. The BFI was validated in patients with chronic idiopathic constipation and is, therefore, not a valid tool for the assessment of OIC D. An increase in her score over time indicates improvement in her symptoms

3. Which lifestyle change can help prevent constipation?

A. Eat a bland, high-fat diet B. Increase physical activity C. Increase intake of coffee D. Wait until there is adequate time to have a complete bowel movement

4. Which of the following is a peripherally acting mu-opioid receptor antagonist?

A. Lubiprostone B. Senna C. Psyllium D. Naloxegol

5. All of the following therapies are approved by the U.S. Food and Drug Administration for the treatment of opioid-induced constipation EXCEPT:

A. Naloxegol B. Lubiprostone C. Alvimopan D. Methylnaltrexone

6. A 47-year-old male is currently receiving extended-release oxycodone 20 mg orally twice daily for chronic pain plus oxycodone 5 mg orally every 6 hours as needed for breakthrough pain and senna 2 tablets (17.2 mg) orally at bedtime. He has been on this regimen for 8 weeks. Today he complains of continued constipation. His Bowel Function Index mean score is 42. Which of the following options is the best recommendation for this patient's constipation based on efficacy, safety, and convenience?

A. Reduce extended-release oxycodone dose to 10 mg orally twice daily B. Add methylnaltrexone 12 mg subcutaneously every morning C. Add docusate 200 mg orally once daily at bedtime D. Add naloxegol 25 mg orally once daily

7. Based on survey results of patients who use opioids to treat chronic pain and experience opioid-induced constipation (OIC), which of the following statements describes patients' and their health care providers' experiences?

A. The majority of patients will not adjust their opioid therapy in response to adverse effects B. The majority of patients who reported altering opioid therapy did so due to sedative effects C. Health care providers are likely to discuss OIC with patients when initiating opioid therapy D. Health care providers accurately estimate their patients' OIC, but underestimate the amount of pain experienced

8. A 67-year-old woman is experiencing opioid-induced constipation (OIC). Her current medications include: hydrocodone 10 mg/acetaminophen 300 mg orally every 4 hours, extended-release venlafaxine 150 mg orally daily, senna 2 tablets orally at bedtime, and polyethylene glycol 3350 17 gm orally once daily. Her diet is high in fruits, vegetables, and whole grains, and she drinks 8 to 10 glasses of water per day. Her past medical history is significant for depression, irritable bowel syndrome with constipation, and a motor vehicle accident 6 months ago with subsequent chronic pain. She is enrolled in a physical therapy program that requires her to be physically active within her ability for approximately 30 minutes per day. Which of the following approaches would be most appropriate to initiate to treat OIC in this patient?

A. Discontinue venlafaxine as this may exacerbate her constipation B. Initiate lubiprostone 24 mcg orally twice daily C. Increase water intake D. Increase physical activity

9. A 54-year-old man with chronic pain is being initiated on chronic opioid therapy. Which of the following recommendations is best for this patient?

A. Initiate naloxegol 25 mg orally once daily concurrently with chronic opioid therapy B. Assess patient after 3 months of opioid therapy and initiate lubiprostone 24 mcg orally twice daily if opioid-induced constipation is present C. Conduct a Bowel Function Index assessment prior to starting opioid therapy and initiate fiber supplementation only if the mean score is above 28.8 D. Initiate bisacodyl 10 mg orally once daily concurrently with the initiation of opioid therapy

10. Which of the following statements is correct regarding the prolonged-release oxycodone and naloxone combination product?

A. Orally administered naloxone undergoes first-pass metabolism, but high doses can achieve concentrations that antagonize analgesic effects centrally B. Prolonged-release oxycodone and naloxone is only effective for opioid-induced constipation (OIC) treatment when used in combination with a peripherally acting mu-opioid receptor antagonist such as naloxegol C. The naloxone in the combination product is present only to induce withdrawal to deter abuse and will not result is improvement in OIC D. Patients treated with the combination product for 12 weeks reported an average reduction of 48.5 points on the Bowel Function Index, which was statistically significant but not clinically significant

Maintenance is scheduled for 05/16/2024 5:00 PM EST - 05/17/2024 5:00 AM EST.

{{recommendationsA.Title}}

{{recommendationsB.Title}}

1. Opioids induce constipation primarily through gastrointestinal stimulation of what receptor?

3. Which lifestyle change can help prevent constipation?

4. Which of the following is a peripherally acting mu-opioid receptor antagonist?

5. All of the following therapies are approved by the U.S. Food and Drug Administration for the treatment of opioid-induced constipation EXCEPT:

7. Based on survey results of patients who use opioids to treat chronic pain and experience opioid-induced constipation (OIC), which of the following statements describes patients' and their health care providers' experiences?

9. A 54-year-old man with chronic pain is being initiated on chronic opioid therapy. Which of the following recommendations is best for this patient?

10. Which of the following statements is correct regarding the prolonged-release oxycodone and naloxone combination product?

« Return to Activity

Maintenance is scheduled for 05/16/2024 5:00 PM EST - 05/17/2024 5:00 AM EST.

The shopping cart is empty

Customers who Purchasedthis Activity also Purchased

{{recommendationsA.Title}}

{{recommendationsB.Title}}

1. Opioids induce constipation primarily through gastrointestinal stimulation of what receptor?

3. Which lifestyle change can help prevent constipation?

4. Which of the following is a peripherally acting mu-opioid receptor antagonist?

5. All of the following therapies are approved by the U.S. Food and Drug Administration for the treatment of opioid-induced constipation EXCEPT:

7. Based on survey results of patients who use opioids to treat chronic pain and experience opioid-induced constipation (OIC), which of the following statements describes patients' and their health care providers' experiences?

9. A 54-year-old man with chronic pain is being initiated on chronic opioid therapy. Which of the following recommendations is best for this patient?

10. Which of the following statements is correct regarding the prolonged-release oxycodone and naloxone combination product?

« Return to Activity

Customers who Purchased
this Activity also Purchased