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Pharmacology and Medication-Assisted Treatment Flashcards

7 cards from real CASAC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Pharmacology and Medication-Assisted Treatment flashcards as text

  1. A client on buprenorphine/naloxone reports severe precipitated withdrawal 30 minutes after taking the first dose. What is the most likely explanation?

    Answer: The client used opioids too recently before dosing

    Precipitated withdrawal occurs when buprenorphine displaces full opioid agonists from receptors before the client is in sufficient withdrawal, typically if opioids were used too recently.

  2. Which medication used in MAT is classified as a Schedule III controlled substance by the DEA?

    Answer: Buprenorphine

    Buprenorphine is classified as a Schedule III controlled substance due to its partial agonist properties and lower abuse potential compared to full opioid agonists.

  3. Acamprosate (Campral) is thought to reduce alcohol cravings primarily by modulating which neurotransmitter system?

    Answer: Glutamate and GABA systems

    Acamprosate is believed to restore balance between glutamate (excitatory) and GABA (inhibitory) neurotransmission disrupted by chronic alcohol use.

  4. A client with opioid use disorder has severe liver disease. Which MAT option requires the most careful evaluation due to hepatic metabolism concerns?

    Answer: Methadone

    Methadone is extensively metabolized by the liver (CYP3A4/CYP2D6), and hepatic impairment can significantly alter its plasma levels and increase toxicity risk.

  5. When a client receives naloxone (Narcan) for an opioid overdose reversal and then regains consciousness, what is a primary concern for the counselor to communicate?

    Answer: The client may re-enter overdose as naloxone wears off faster than many opioids

    Naloxone has a shorter half-life (30–90 minutes) than most opioids, meaning the client can slip back into overdose when naloxone wears off — requiring medical observation.

  6. A CASAC counselor notices a client on methadone maintenance is also prescribed erythromycin by their primary care physician. What pharmacological concern should be raised?

    Answer: Erythromycin inhibits CYP3A4, potentially increasing methadone plasma levels and QTc risk

    Erythromycin is a CYP3A4 inhibitor that can elevate methadone blood levels and prolong the QTc interval, increasing risk of life-threatening arrhythmia.

  7. Under current SAMHSA regulations, which of the following professionals is NOT authorized to prescribe buprenorphine for opioid use disorder in an office-based setting?

    Answer: Licensed clinical social workers with specialized training

    Licensed clinical social workers are not authorized to prescribe medications; only licensed prescribers (MDs, DOs, NPs, PAs, CNMs, CRNAs) with appropriate waivers may prescribe buprenorphine.