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1.5 CE Test Hours

Acute Pain Management for People with Opioid Use Disorder

Contrada, Emily

AJN The American Journal of Nursing: October 2018 - Volume 118 - Issue 10 - p 39,40
doi: 10.1097/01.NAJ.0000546379.58679.13
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Acute Pain Management for People with Opioid Use Disorder


To provide information about the 3 medications used to treat opioid use disorder.

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After completing this continuing education activity, you should be able to

  • outline attributes of methadone, buprenorphine, and naltrexone.
  • explain how to manage acute pain in patients receiving these drugs.
  1. The term the American Psychiatric Association now uses as a single category to encompass the various forms of substance use is
    1. substance use disorders.
    2. substance abuse disorders.
    3. substance-related disorders.
  2. When methadone is administered daily to treat opioid use disorder (OUD), it reduces craving by
    1. blocking the euphoric effects of opioids.
    2. causing distressing symptoms with opioid use.
    3. inducing euphoric feelings with little risk of addiction.
  3. When methadone is used to suppress opioid withdrawal symptoms, its duration of action is
    1. 4 to 8 hours.
    2. 12 to 16 hours.
    3. 24 to 48 hours.
  4. Taking methadone concurrently with which of the following medications may put patients at risk for torsade de pointes?
    1. propranolol
    2. haloperidol
    3. metformin
  5. For acute pain management in patients who take methadone to treat OUD, it is helpful to
    1. administer smaller doses of methadone every 6 or 8 hours.
    2. reduce the usual once-daily dosage of methadone by half.
    3. replace methadone with buprenorphine.
  6. Some patients who need acute pain management and take methadone for OUD may benefit from the addition of which of the following medications to the regimen?
    1. amitriptyline
    2. midazolam
    3. hydromorphone
  7. Buprenorphine's effects can last for up to how many days?
    1. 3
    2. 4
    3. 5
  8. Buprenorphine can prevent opioid withdrawal symptoms for
    1. up to 8 hours.
    2. about 16 hours.
    3. more than 24 hours.
  9. Patients who have both OUD and chronic pain are often scheduled to take buprenorphine every
    1. 8 hours.
    2. 12 hours.
    3. 24 hours.
  10. Patients who have had buprenorphine discontinued during hospitalization and require pain relief might need higher opioid doses for
    1. 12 to 24 hours.
    2. 24 to 72 hours.
    3. 72 to 96 hours.
  11. Hospitalized patients receiving higher opioid doses for pain relief when buprenorphine has been discontinued require diligent monitoring for
    1. respiratory depression.
    2. electrolyte imbalances.
    3. cardiac dysrhythmias.
  12. Patients who take oral naltrexone 3 times weekly follow the first 2 100-mg doses with a third dose of
    1. 50 mg.
    2. 100 mg.
    3. 150 mg.
  13. An extended-release formulation of naltrexone can be administered via intramuscular injection every
    1. 2 weeks.
    2. 4 weeks.
    3. 6 weeks.
  14. Which of the following medications for treating OUD is a good choice for patients who undergo routine job-related urine drug testing and choose not to disclose a diagnosis of OUD?
    1. naltrexone
    2. methadone
    3. buprenorphine
  15. How long prior to elective surgery should patients who receive intramuscular naltrexone discontinue its use?
    1. 3 days
    2. 2 weeks
    3. 1 month
  16. Patients receiving naltrexone who require emergency surgery might need how many times the usual opioid dose to manage their pain?
    1. 2 to 10
    2. 10 to 20
    3. 20 to 30
  17. Patients receiving naltrexone may require multimodal pain management supplemented with
    1. nonopioid analgesics.
    2. glucocorticoids.
    3. antidepressants.
  18. Naltrexone may put patients at risk for
    1. cardiotoxicity.
    2. neurotoxicity.
    3. hepatotoxicity.
  19. The usual dose of methadone is how many milligrams by mouth daily?
    1. 30 to 60
    2. 60 to 120
    3. 120 to 150
  20. Using larger amounts of substances or for longer periods than intended, with unsuccessful attempts to reduce use, describes which category of substance use disorder?
    1. impaired control
    2. social impairment
    3. risky use
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