Addiction Medicine Certification Addiction Medicine Pharmacotherapy 4

Question 1

Lofexidine (Lucemyra) is FDA-approved for which specific indication related to opioid use disorder?

Accepted Answer

Management of acute opioid withdrawal symptoms

Answer

Lofexidine is the first non-opioid FDA-approved medication specifically for managing opioid withdrawal symptoms, acting as an alpha-2 adrenergic agonist to reduce autonomic symptoms.

Question 2

A patient presents with nicotine use disorder and comorbid major depression. Which pharmacotherapy combination has the strongest evidence for this population?

Accepted Answer

Bupropion SR combined with NRT

Answer

Bupropion SR, which also has antidepressant properties, combined with NRT is particularly beneficial in smokers with comorbid depression; varenicline's neuropsychiatric risks require caution.

Question 3

Which of the following best describes the pharmacological difference between methadone and buprenorphine in treating opioid use disorder?

Accepted Answer

Methadone is a full agonist with long half-life; buprenorphine is a partial agonist with ceiling effect

Answer

Methadone is a full mu-opioid agonist with a long, variable half-life (24–36 hrs), while buprenorphine is a partial agonist with a ceiling effect that limits respiratory depression.

Question 4

What is the rationale for using gabapentin as an adjunct during alcohol withdrawal management?

Accepted Answer

It reduces alcohol cravings and manages withdrawal symptoms with less abuse potential than benzodiazepines

Answer

Gabapentin modulates voltage-gated calcium channels and has evidence for reducing alcohol craving and withdrawal severity with lower abuse potential than benzodiazepines.

Question 5

A patient on buprenorphine/naloxone maintenance develops severe pain requiring opioid analgesia. Which statement is most accurate?

Accepted Answer

High-affinity full opioid agonists at higher doses can compete with buprenorphine and provide analgesia

Answer

Buprenorphine's high receptor affinity can be overcome by high-dose full agonists (e.g., fentanyl, hydromorphone) in monitored settings, or buprenorphine dosing can be adjusted for acute pain.

Addiction Medicine Certification Practice Test

Addiction Medicine Certification Practice Test

Addiction Medicine Certification Addiction Medicine Pharmacotherapy 4