Post-learning assessment

Is the following statement true or false?

An antagonist (neutral or negative) medication completely blocks the euphoric and analgesic effects of all other opioids

Patient monitoring is a vital part of therapy. All medication reviews should be tailored to the individual patient, as the needs and challenges they face will change over time.

How often should a patient be monitored during induction and titration up to maintenance dose of ODT?

Which of the following transfer techniques do not require the patient to be in withdrawal prior to transfer from methadone to BPN?

The aim of medication assisted treatment is for the medication prescribed to stop withdrawal experience and cravings  whilst not causing intoxication (e.g., sedation). However, patients sometimes relapse or struggle with external environmental factors and take other substances on top of their prescribed medication.

How often should you set up in depth review appointments (as opposed to monitoring appointments)?

The patient is a 54-year-old man who owns a roofing company and fell off a ladder resulting in a shattered pelvis. He has had several surgeries to repair the damage, initially prescribed tramadol but complained of chronic pain and was prescribed increasingly high dosages of oxycodone. The patient realised he was developing an addiction to oxycodone and wanted to enter treatment to prevent this.

Which of the following ODT options would NOT be a suitable therapy for this patient?

The patient is a 37-year-old male who has a history of heroin injection. He has been in ODT for 6 months with daily sublingual BPN appointments. During the consultation, the patient informs you that he has recently had a chest infection, was treated with erythromycin.

What are the next steps?

A 35-year-old male has been on methadone maintenance treatment dose of 80 mg for the past 2 years and has decided to change from methadone to BPN. The patient discontinued the transfer, complaining of increased anxiety, tremors, and digestive discomfort. During the course of the transfer attempt, the patient admitted to seeking illicit drugs to alleviate discomfort.

What would be a potential method to transfer the patient from methadone to BPN?  

The patient is a 30-year-old female who has become dependent on tramadol following an injury at work. The patient has been tolerating an extended-release BPN medication for a year but has since lost her job and is starting to struggle.

What are the next steps?