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The Peripheral Neuropathy Solution

The Peripheral Neuropathy Program

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1. Which of the following statements is true?

a. Older adults tend to be less sensitive than their younger counterparts to the analgesic effects of opioids.

b. Mixing an angonist-antagonist opioid with a pure opioid agonist can result in withdrawal syndrome.

c. Morphine is a partial opioid agonist with a "ceiling" effect, in which dosage beyond a certain level will not result in additional analgesia.

d. None of the above statements are true.

2. Which of the following is not a reasonable response to opioid-in-

duced constipation?

a. use of a stimulant laxative b. use of milk of magnesia c. increase in dietary fiber d. use of a stool softener

3. Opioids that are good alternatives to morphine because their metabolites have negligible or no activity include:

a. methadone, hydromorphone, and codeine b. hydromorphone, codeine, and propoxyphene c. oxycodone, hydromorphone, and fentanyl d. fentanyl, meperidine, and propoxyphene

4. Which of the following statements is false?

a. In the treatment of neuropathic pain, gabapentin has fewer adverse effects and drug interactions than phenytoin or carbamazepine.

b. In the treatment of neuropathic pain in older adults, secondary amines are often preferred to tertiary amines because they cause fewer sedative effects.

c. Neuropathic pain can most often be controlled by opioids alone.

d. Selective serotonin reuptake inhibitor antidepressants have not demonstrated significant efficacy in treating neuropathic pain.

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