BCACP Mental Health and Substance Use Disorders 5

Question 1

A patient with alcohol use disorder (AUD) is started on acamprosate. Which patient population is acamprosate CONTRAINDICATED in?

Accepted Answer

Patients with severe renal impairment (CrCl < 30 mL/min)

Answer

Acamprosate is renally eliminated and is contraindicated in patients with severe renal impairment (CrCl < 30 mL/min), unlike naltrexone which is contraindicated in hepatic failure.

Question 2

A patient with PTSD is not responding to sertraline. Which medication is the ONLY other FDA-approved pharmacotherapy specifically indicated for PTSD?

Accepted Answer

Paroxetine

Answer

Paroxetine (Paxil) is the only other FDA-approved medication for PTSD besides sertraline; venlafaxine and prazosin are used off-label.

Question 3

Which stimulant medication for ADHD is classified as Schedule II and requires a new written prescription for each fill with NO refills permitted?

Accepted Answer

Methylphenidate (Ritalin)

Answer

Methylphenidate is a Schedule II controlled substance; federal law prohibits refills, and a new prescription is required for each 30-day supply.

Question 4

A patient with bipolar depression is initiated on quetiapine. What is the FDA-approved dose range for quetiapine in bipolar depression?

Accepted Answer

300–600 mg/day

Answer

The FDA-approved dose for quetiapine in bipolar depression is 300–600 mg/day, typically titrated over several days.

Question 5

A patient taking phenelzine (an MAOI) for treatment-resistant depression requests tramadol for pain. What is the MOST serious risk of this combination?

Accepted Answer

Serotonin syndrome

Answer

Tramadol inhibits serotonin reuptake and combined with an MAOI creates a potentially life-threatening serotonin syndrome.

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP - Board Certified Ambulatory Care Pharmacist Exam Practice Test

BCACP Mental Health and Substance Use Disorders 5