NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

What happens when the opioid dose is increased but pain becomes worse rather than better?

1. Opioid hyperalgesia

2. Break-through pain

3. Respiratory depression

4. Serotonin syndrome

The correct answer is: Opioid hyperalgesia

When the opioid dose is increased but pain becomes worse rather than better, it could be indicative of opioid hyperalgesia. Opioid hyperalgesia is a paradoxical phenomenon where increased opioid dosage leads to increased sensitivity to pain stimuli rather than pain relief. This can result in the patient experiencing heightened pain levels despite higher opioid doses. Break-through pain refers to a transient exacerbation of pain that occurs despite the patient being on a stable, around-the-clock opioid regimen. It is typically managed with additional doses of short-acting opioids. Respiratory depression is a potential side effect of opioid use, characterized by slow and shallow breathing. It is more commonly associated with opioid overdose rather than worsening pain with increased dosages. Serotonin syndrome is a potentially life-threatening condition that can occur due to drug interactions or increased serotonin levels in the body. It is not directly related to the scenario described in the question.