Chemical Dependency Counselor License Exam Pharmacology of Substance Use 2

Question 1

Which neurotransmitter system is primarily responsible for the euphoric reinforcement produced by opioids?

Accepted Answer

Dopamine in the mesolimbic pathway

Answer

Serotonin in the raphe nuclei

Answer

GABA in the cerebellum

Answer

Acetylcholine in the basal ganglia

Question 2

A client taking methadone for OUD is prescribed erythromycin for a bacterial infection. The primary pharmacological concern is:

Accepted Answer

QTc interval prolongation due to combined CYP3A4 inhibition

Answer

Erythromycin blocking methadone absorption in the gut

Answer

Increased methadone clearance causing withdrawal

Answer

Erythromycin cross-reacting with opioid receptors

Question 3

Which benzodiazepine property makes it most likely to produce severe withdrawal seizures upon abrupt discontinuation?

Accepted Answer

Short half-life with high potency

Answer

High lipid solubility

Answer

Long elimination half-life

Answer

Selective GABA-A alpha-1 binding

Question 4

Cocaine's mechanism of action primarily involves:

Accepted Answer

Blocking reuptake of dopamine, norepinephrine, and serotonin

Answer

Activating dopamine D2 receptors directly

Answer

Stimulating dopamine release from presynaptic vesicles

Answer

Inhibiting monoamine oxidase

Question 5

Naltrexone is contraindicated in a client who:

Accepted Answer

Used heroin within the past 7–10 days

Answer

Has hepatitis C with normal liver enzymes

Answer

Is currently on antidepressant therapy

Answer

Has a history of alcohol use disorder

Question 6

Which statement best describes the pharmacokinetics of inhaled crack cocaine compared to intranasal powder cocaine?

Accepted Answer

Smoked crack reaches peak brain concentration in seconds, producing a more intense but shorter high

Answer

Smoked crack has slower onset but longer duration

Answer

Intranasal powder reaches the brain faster due to direct nasal-to-brain transport

Answer

Both routes have identical onset and duration

Question 7

The Wernicke-Korsakoff syndrome seen in chronic alcohol users is caused by deficiency of:

Accepted Answer

Thiamine (vitamin B1)

Answer

Vitamin B12 (cobalamin)

Answer

Folate

Answer

Niacin (vitamin B3)