Detox Detox Medications and Pharmacology 1 — Questions and Answers
Question 1: What is the mechanism of action of naltrexone in treating alcohol use disorder after detox?
- It blocks dopamine receptors, reducing euphoria
- It binds opioid receptors and reduces the rewarding effects of alcohol (Correct answer)
- It acts as a GABA agonist to ease cravings
- It increases serotonin to improve mood
Correct answer: It binds opioid receptors and reduces the rewarding effects of alcohol
Naltrexone blocks opioid receptors involved in alcohol's reward pathway, reducing the pleasurable effects of drinking and decreasing cravings.
Question 2: Which benzodiazepine is preferred for alcohol detox in patients with severe liver disease?
- Diazepam (Valium)
- Chlordiazepoxide (Librium)
- Lorazepam (Ativan) (Correct answer)
- Alprazolam (Xanax)
Correct answer: Lorazepam (Ativan)
Lorazepam is preferred in liver disease because it undergoes direct glucuronidation without active metabolites, reducing accumulation risk.
Question 3: What is the risk of administering glucose-containing IV fluids BEFORE thiamine in a malnourished alcoholic?
- Hyperglycemic coma
- Precipitating Wernicke's encephalopathy by depleting remaining thiamine stores (Correct answer)
- Causing immediate seizure activity
- Inducing refeeding syndrome only
Correct answer: Precipitating Wernicke's encephalopathy by depleting remaining thiamine stores
Giving glucose before thiamine in a thiamine-deficient patient can acutely deplete remaining thiamine, precipitating Wernicke's encephalopathy.
Question 4: Disulfiram (Antabuse) is used in alcohol use disorder treatment by which mechanism?
- Reducing alcohol cravings via opioid receptor blockade
- Causing an aversive reaction when alcohol is consumed by blocking acetaldehyde metabolism (Correct answer)
- Mimicking alcohol's effects to prevent withdrawal
- Increasing GABA activity to reduce anxiety
Correct answer: Causing an aversive reaction when alcohol is consumed by blocking acetaldehyde metabolism
Disulfiram inhibits acetaldehyde dehydrogenase, causing acetaldehyde buildup when alcohol is consumed, producing a highly unpleasant reaction.
Question 5: Which medication is used in opioid detox to suppress withdrawal symptoms by acting as a partial opioid agonist?
- Naloxone
- Clonidine
- Buprenorphine (Correct answer)
- Methadone
Correct answer: Buprenorphine
Buprenorphine is a partial opioid agonist that activates opioid receptors sufficiently to relieve withdrawal symptoms without producing full euphoric effects.
Question 6: Acamprosate (Campral) helps prevent relapse after alcohol detox by which action?
- Creating an aversive reaction to alcohol
- Blocking dopamine reward pathways
- Restoring GABA/glutamate balance disrupted by chronic alcohol use (Correct answer)
- Increasing endorphin release to substitute for alcohol reward
Correct answer: Restoring GABA/glutamate balance disrupted by chronic alcohol use
Acamprosate modulates GABA and glutamate neurotransmitter systems disrupted by chronic alcohol use, reducing post-detox anxiety and craving.
Detox Detox Medications and Pharmacology 1
What is the mechanism of action of naltrexone in treating alcohol use disorder after detox?