Certified Hospice and Palliative Assistant (CHPNA) Practice Test

What side effect is associated with high dose opioid therapy?

1. Decreased blood pressure

2. Myoclonus due to increased metabolites

3. Reduced heart rate

4. Increased appetite

The correct answer is: Myoclonus due to increased metabolites

High dose opioid therapy is known to cause myoclonus, which is characterized by sudden, involuntary muscle jerks or spasms. This side effect occurs due to an accumulation of opioid metabolites, particularly when higher doses are used or in patients with renal insufficiency. The increased levels of these metabolites can affect the central nervous system, leading to neurological side effects such as myoclonus. In this context, decreased blood pressure and reduced heart rate are not typically primary side effects associated with high-dose opioid use. While opioids can cause a decrease in blood pressure due to their vasodilatory effects, this is not considered a consistent or defining side effect in high-dose therapy compared to myoclonus. Additionally, increased appetite is not a common side effect of opioid therapy; opioids often lead to decreased appetite and gastrointestinal motility rather than an increase. Thus, myoclonus stands out as a specific and well-documented side effect linked to the use of high doses of opioids, primarily attributed to the impact of elevated opioid metabolites in the body.