Pharmacotherapy & Medication-Assisted Treatment Flashcards
7 cards from real ADM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pharmacotherapy & Medication-Assisted Treatment flashcards as text
A patient on buprenorphine/naloxone reports severe pain after a traumatic injury. Which analgesic strategy is most appropriate?
Answer: Continue buprenorphine and add non-opioid analgesics plus titrate buprenorphine dose upward if needed
Buprenorphine should generally be continued and non-opioid multimodal analgesia added; buprenorphine itself provides partial analgesia and abrupt discontinuation risks relapse.
Which pharmacokinetic property makes once-monthly injectable buprenorphine (Sublocade) advantageous over daily sublingual formulations?
Answer: Elimination of peak-and-trough plasma fluctuations
The subcutaneous depot provides sustained, steady plasma levels, eliminating the peaks and troughs associated with daily sublingual dosing.
A patient maintained on methadone 100 mg/day is started on rifampin for tuberculosis. The expected pharmacokinetic interaction is:
Answer: Rifampin induces CYP3A4, markedly decreasing methadone levels and precipitating withdrawal
Rifampin is a potent CYP3A4 inducer that accelerates methadone metabolism, often requiring a 50–100% dose increase to prevent withdrawal.
Naltrexone extended-release injectable (XR-NTX) is contraindicated within how many days of last opioid use to avoid precipitated withdrawal?
Answer: 7–10 days
A minimum 7–10 day opioid-free period is required before initiating XR-NTX to avoid precipitated withdrawal from opioid receptor blockade.
Which statement about acamprosate's mechanism of action in alcohol use disorder is correct?
Answer: It modulates GABA-A receptors and inhibits NMDA receptors to reduce glutamatergic hyperactivity
Acamprosate is thought to restore balance between inhibitory GABA and excitatory glutamate (NMDA) systems dysregulated by chronic alcohol exposure.
A woman with OUD is 28 weeks pregnant and using heroin daily. She has no prior MAT. Which is the recommended first-line approach?
Answer: Initiation of methadone or buprenorphine maintenance therapy
Methadone and buprenorphine are the evidence-based standard of care for OUD in pregnancy; opioid withdrawal in pregnancy is associated with fetal distress and preterm labor.
Which medication used for alcohol use disorder requires a disulfiram-alcohol reaction test before prescribing to confirm the mechanism?
Answer: Disulfiram
Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation when alcohol is consumed, producing flushing, nausea, and cardiovascular symptoms as a deterrent.