Pharmacology & Co-Occurring Disorders 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 & Co-Occurring Disorders flashcards as text
A client with opioid use disorder on buprenorphine also has hepatic impairment. Which concern is MOST clinically relevant?
Answer: Buprenorphine is hepatically metabolized via CYP3A4; severe impairment may increase plasma levels
Buprenorphine is primarily metabolized by CYP3A4 in the liver; severe hepatic impairment reduces clearance, leading to potential drug accumulation and toxicity.
Which of the following best describes the 'kindling' phenomenon relevant to alcohol use disorder?
Answer: The progressive worsening of withdrawal severity with each repeated episode of detoxification
Kindling refers to the neurobiological process whereby each successive alcohol withdrawal episode becomes more severe, increasing seizure risk with repeated detoxifications.
A client with schizophrenia and alcohol use disorder is prescribed quetiapine. The counselor should be aware that quetiapine:
Answer: Has sedating properties that may be misused and should be monitored in SUD populations
Quetiapine's sedating properties have led to its misuse in SUD populations, where it may be sought for sleep or 'high,' requiring careful monitoring.
Extended-release naltrexone (Vivitrol) is administered by injection monthly. What is the PRIMARY advantage of this formulation over oral naltrexone?
Answer: It removes the daily adherence barrier, bypassing the decision to take a pill each day
Monthly injectable naltrexone removes daily decision-making about taking medication, which is critical given that relapse motivation can override pill-taking compliance.
Which substance class is most likely to cause a life-threatening withdrawal syndrome without appropriate medical management?
Answer: Alcohol and benzodiazepines
Alcohol and benzodiazepine withdrawal can cause seizures, delirium tremens, and death due to CNS hyperexcitability; opioid withdrawal, while severe, is rarely fatal in otherwise healthy adults.
A client with generalized anxiety disorder and benzodiazepine use disorder is stabilized and seeking alternatives. Which medication class is FDA-approved and non-addictive for GAD?
Answer: SSRIs/SNRIs and buspirone
SSRIs, SNRIs, and buspirone are FDA-approved for GAD and carry no addiction liability, making them preferred for patients with co-occurring SUD.
When treating co-occurring depression and opioid use disorder, buprenorphine itself may have antidepressant properties. This is hypothesized to be due to:
Answer: Partial mu agonism and kappa opioid antagonism, which may reduce dysphoria
Buprenorphine's kappa opioid receptor antagonism is believed to reduce dysphoria and depression, distinguishing its mood effects from full mu agonists.