Addictions and Substance Use Counseling Flashcards

Disulfiram (Antabuse) deters drinking mainly by which mechanism?

Answer: Inhibiting aldehyde dehydrogenase so acetaldehyde builds up

Disulfiram blocks aldehyde dehydrogenase, so drinking causes acetaldehyde buildup with flushing, nausea, and palpitations.

Before starting naltrexone, a client with a history of opioid use should usually be opioid-free for about how long?

Answer: 7 to 10 days

Naltrexone is an opioid antagonist, so starting it while opioids are still in the body can cause precipitated withdrawal; 7 to 10 days opioid-free is typical.

Which alcohol use disorder medication is thought to work by modulating glutamate and needs dose adjustment for kidney impairment?

Answer: Acamprosate

Acamprosate is believed to restore the glutamate/GABA balance and is cleared by the kidneys, so renal function guides dosing.

A client gets buprenorphine soon after using a full opioid agonist and suddenly develops severe withdrawal. What does this most likely show?

Answer: Precipitated withdrawal caused by buprenorphine's high-affinity partial agonism

Buprenorphine binds tightly as a partial agonist and displaces full agonists, which can trigger precipitated withdrawal if it is started too early.

Which medication rapidly reverses an opioid overdose and is available over the counter as a nasal spray in the U.S.?

Answer: Naloxone

Naloxone is a short-acting opioid antagonist that reverses respiratory depression, and the FDA approved OTC nasal naloxone in 2023.

A client with long-term heavy alcohol use shows confusion, ataxia, and abnormal eye movements. Which deficiency is most likely?

Answer: Thiamine (vitamin B1)

These signs are the classic triad of Wernicke encephalopathy, which is caused by thiamine deficiency and is treated urgently with thiamine.

When does delirium tremens (DTs) usually begin after a client's last drink?

Answer: About 48 to 96 hours

DTs usually appear 48 to 96 hours after the last drink and are a medical emergency.