CASAC Pharmacology & Co-Occurring Disorders 4

Question 1

A client with opioid use disorder on buprenorphine also has hepatic impairment. Which concern is MOST clinically relevant?

Accepted Answer

Buprenorphine is hepatically metabolized via CYP3A4; severe impairment may increase plasma levels

Answer

Buprenorphine is primarily metabolized by CYP3A4 in the liver; severe hepatic impairment reduces clearance, leading to potential drug accumulation and toxicity.

Question 2

Which of the following best describes the 'kindling' phenomenon relevant to alcohol use disorder?

Accepted Answer

The progressive worsening of withdrawal severity with each repeated episode of detoxification

Answer

Kindling refers to the neurobiological process whereby each successive alcohol withdrawal episode becomes more severe, increasing seizure risk with repeated detoxifications.

Question 3

A client with schizophrenia and alcohol use disorder is prescribed quetiapine. The counselor should be aware that quetiapine:

Accepted Answer

Has sedating properties that may be misused and should be monitored in SUD populations

Answer

Quetiapine's sedating properties have led to its misuse in SUD populations, where it may be sought for sleep or 'high,' requiring careful monitoring.

Question 4

Extended-release naltrexone (Vivitrol) is administered by injection monthly. What is the PRIMARY advantage of this formulation over oral naltrexone?

Accepted Answer

It removes the daily adherence barrier, bypassing the decision to take a pill each day

Answer

Monthly injectable naltrexone removes daily decision-making about taking medication, which is critical given that relapse motivation can override pill-taking compliance.

Question 5

Which substance class is most likely to cause a life-threatening withdrawal syndrome without appropriate medical management?

Accepted Answer

Alcohol and benzodiazepines

Answer

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.

CASAC - Credentialed Alcoholism and Substance Abuse Counselor Practice Test

CASAC - Credentialed Alcoholism and Substance Abuse Counselor Practice Test

CASAC Pharmacology & Co-Occurring Disorders 4