Certified Hospice and Palliative Assistant (CHPNA) Practice Test

Which scenario is most appropriate for the use of tricyclic antidepressants as an adjuvant analgesic?

1. A patient with severe hypertension

2. A patient with chronic constipation

3. A patient experiencing diarrhea

4. A patient with neuropathic pain

The correct answer is: A patient experiencing diarrhea

Tricyclic antidepressants are commonly used as adjuvant analgesics, particularly for managing neuropathic pain. This class of medications can help alleviate pain by modulating neurotransmitters in the brain that affect pain perception. They are especially beneficial for conditions characterized by nerve injury or dysfunction, such as diabetic neuropathy or post-herpetic neuralgia. In the situation where a patient is experiencing neuropathic pain, using tricyclic antidepressants can provide significant relief. These medications can improve quality of life and support overall pain management, making them a suitable choice in this specific case. Comparatively, the other scenarios mentioned present conditions for which tricyclic antidepressants are not indicated. Severe hypertension could be exacerbated by certain tricyclics, chronic constipation is generally treated with different approaches, and diarrhea would not typically benefit from the constipating effects of these antidepressants. Therefore, the use of tricyclic antidepressants is most appropriate for patients experiencing neuropathic pain, as they effectively target the underlying mechanisms of this type of pain.