Chemical Dependency Counselor License Exam Pharmacology of Substance Use 4

Question 1

Disulfiram (Antabuse) produces its aversive effect by inhibiting which enzyme?

Accepted Answer

Aldehyde dehydrogenase (ALDH)

Answer

Alcohol dehydrogenase (ADH)

Answer

CYP2E1

Answer

Monoamine oxidase (MAO)

Question 2

Which cannabinoid receptor subtype mediates most of THC's psychoactive effects?

Accepted Answer

CB1 receptors in the central nervous system

Answer

CB2 receptors in peripheral immune tissue

Answer

Opioid mu receptors in the limbic system

Answer

TRP vanilloid channels in sensory neurons

Question 3

Acamprosate's therapeutic mechanism in alcohol use disorder involves:

Accepted Answer

Modulating glutamate and GABA activity to reduce post-acute withdrawal symptoms

Answer

Blocking opioid reward pathways to reduce craving

Answer

Producing aversive reactions when alcohol is consumed

Answer

Replacing alcohol at GABA-A receptors to prevent withdrawal seizures

Question 4

Phencyclidine (PCP) produces its distinctive dissociative effects primarily by:

Accepted Answer

Noncompetitively antagonizing NMDA glutamate receptors

Answer

Agonizing sigma receptors in the limbic cortex

Answer

Releasing large amounts of serotonin like MDMA

Answer

Blocking dopamine reuptake similar to cocaine

Question 5

A client on buprenorphine maintenance presents with acute severe pain after a car accident. The MOST appropriate analgesic strategy is:

Accepted Answer

Continue buprenorphine and add non-opioid analgesics plus, if needed, high-dose full agonist opioids

Answer

Discontinue buprenorphine and start full agonist opioids

Answer

Switch to methadone immediately for better analgesic coverage

Answer

Administer naloxone to clear receptors before opioid analgesia

Question 6

Inhalant intoxication leading to 'sudden sniffing death' is most commonly caused by:

Accepted Answer

Cardiac arrhythmia triggered by catecholamine sensitization of the myocardium

Answer

Hypoxic brain injury from displaced oxygen

Answer

Acute liver necrosis from chlorinated solvent metabolites

Answer

Pulmonary edema from direct alveolar toxicity

Question 7

Which statement about nicotine pharmacology is MOST accurate?

Accepted Answer

Nicotine stimulates nicotinic acetylcholine receptors, ultimately increasing mesolimbic dopamine

Answer

Nicotine acts solely on mu-opioid receptors to produce dependence

Answer

Nicotine's half-life is approximately 24 hours, explaining daily cravings

Answer

Nicotine replacement therapy delivers nicotine faster than cigarettes