Rhode Island Multistate Pharmacy Jurisprudence (MPJE) Practice Exam

When is co-prescribing naloxone necessary?

1. When prescribed more than 100 MME

2. When the patient receives benzodiazepines in the past 30 days

3. When receiving more than 50 MME of opioids or has a history of misuse

4. Always when opioids are prescribed

The correct answer is: When receiving more than 50 MME of opioids or has a history of misuse

Co-prescribing naloxone is particularly important when a patient is receiving more than 50 morphine milligram equivalents (MME) of opioids or has a history of opioid misuse. This practice is rooted in the understanding that patients in these categories are at an increased risk of opioid overdose, which can be life-threatening. The rationale behind this guideline is to ensure that naloxone, an opioid antagonist that can reverse the effects of an opioid overdose, is readily available to prevent fatal outcomes in vulnerable patients. While prescribing naloxone for patients receiving more than 100 MME or those who have received benzodiazepines recently are also significant considerations, they fall within broader risk assessment frameworks rather than the standard threshold for initiating co-prescribing practices. Furthermore, while it may seem prudent to co-prescribe naloxone for all patients receiving opioids, doing so universally may be deemed unnecessary and impractical in some clinical situations where the risk level is lower. Thus, focusing on those receiving more than 50 MME or with a history of misuse provides a targeted approach in safeguarding at-risk patients effectively.