BCACP Mental Health and Substance Use Disorders 2

Question 1

Which medication is first-line for generalized anxiety disorder (GAD) pharmacotherapy in ambulatory care?

Accepted Answer

Buspirone or an SSRI/SNRI

Answer

SSRIs, SNRIs, and buspirone are first-line for GAD due to efficacy without the dependence risk of benzodiazepines.

Question 2

What is the primary mechanism of action of naltrexone when used for alcohol use disorder?

Accepted Answer

Opioid receptor blockade reducing reward from alcohol

Answer

Naltrexone blocks opioid receptors, reducing the rewarding effects of alcohol and decreasing craving.

Question 3

A patient starting on an SSRI for depression asks when they will begin to feel better. What is the most accurate response?

Accepted Answer

2–4 weeks for mood improvement, up to 6–8 weeks for full effect

Answer

SSRIs typically produce initial mood improvement at 2–4 weeks with full therapeutic effect taking 6–8 weeks.

Question 4

Which atypical antipsychotic requires mandatory enrollment in a REMS program due to risk of agranulocytosis?

Accepted Answer

Clozapine

Answer

Clozapine has a REMS program (CLOZAPINE REMS) requiring ANC monitoring due to its risk of life-threatening agranulocytosis.

Question 5

What is the role of motivational interviewing (MI) in managing substance use disorders in ambulatory care?

Accepted Answer

To use empathy and elicit the patient's own motivation for change

Answer

Motivational interviewing uses reflective listening and empathy to help patients explore ambivalence and strengthen their own motivation to change.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test