Addiction Medicine Certification Pharmacology & Medication Management 3

Question 1

Extended-release naltrexone (Vivitrol) for opioid use disorder is administered as:

Accepted Answer

A monthly intramuscular injection of 380mg

Answer

Vivitrol is administered as a 380mg IM gluteal injection once monthly, which improves adherence by eliminating the need for daily dosing.

Question 2

A patient on buprenorphine/naloxone reports using fentanyl, and urine drug screening is negative for buprenorphine. The most likely explanation is:

Accepted Answer

The patient is not taking the buprenorphine as prescribed (diversion)

Answer

Absence of buprenorphine in urine combined with ongoing illicit drug use strongly suggests the patient is not taking (and likely diverting) the prescribed medication.

Question 3

Which drug-drug interaction is most clinically significant for a patient on methadone maintenance who is started on rifampin for tuberculosis?

Accepted Answer

Rifampin induces CYP3A4, significantly decreasing methadone levels and precipitating withdrawal

Answer

Rifampin is a potent CYP3A4 inducer that dramatically lowers methadone plasma levels, often precipitating opioid withdrawal and requiring substantial methadone dose increases.

Question 4

For a pregnant patient with opioid use disorder, which treatment approach is recommended by ACOG and SAMHSA?

Accepted Answer

Buprenorphine or methadone maintenance is recommended as the standard of care

Answer

ACOG and SAMHSA recommend opioid agonist therapy (buprenorphine or methadone) as the standard of care in pregnancy because it is associated with better outcomes than withdrawal or no treatment.

Question 5

A patient with alcohol use disorder has a history of alcohol withdrawal seizures. Which medication best prevents recurrence of seizures during withdrawal?

Accepted Answer

Benzodiazepines (e.g., chlordiazepoxide or diazepam)

Answer

Benzodiazepines are the first-line agents for preventing alcohol withdrawal seizures due to their cross-tolerance with alcohol at GABA-A receptors.

Addiction Medicine Certification Practice Test

Addiction Medicine Certification Practice Test

Addiction Medicine Certification Pharmacology & Medication Management 3