LCDC Pharmacology of Addictions 2 — Questions and Answers
Question 1: Which statement best distinguishes physical dependence from addiction?
- Physical dependence always leads to addiction
- Physical dependence involves withdrawal symptoms upon cessation; addiction involves compulsive use despite harm (Correct answer)
- Addiction requires physical dependence to be present
- Physical dependence only occurs with illegal substances
Correct answer: Physical dependence involves withdrawal symptoms upon cessation; addiction involves compulsive use despite harm
Physical dependence is a physiological adaptation resulting in withdrawal symptoms upon abrupt cessation, while addiction (substance use disorder) involves compulsive drug-seeking behavior despite negative consequences.
Question 2: Buprenorphine is effective in treating opioid use disorder primarily because it is:
- A full agonist with a very short half-life
- A partial agonist at mu-opioid receptors with a ceiling effect (Correct answer)
- A complete antagonist at all opioid receptor types
- An NMDA receptor blocker that reduces cravings
Correct answer: A partial agonist at mu-opioid receptors with a ceiling effect
Buprenorphine's partial agonist activity suppresses withdrawal and cravings, while its ceiling effect on respiratory depression makes it safer in overdose compared to full agonists.
Question 3: Tolerance to a drug is best defined as:
- An allergic reaction requiring dose reduction
- The need for increasing amounts of a drug to achieve the same effect (Correct answer)
- The ability to function normally despite intoxication
- A genetic predisposition to substance use disorder
Correct answer: The need for increasing amounts of a drug to achieve the same effect
Tolerance develops when repeated drug exposure leads to diminished effects, requiring higher doses to achieve the original response, often through receptor downregulation or metabolic adaptation.
Question 4: Cannabis exerts its primary psychoactive effects by binding to which receptor system?
- Opioid receptors
- Dopamine receptors
- Endocannabinoid (CB1 and CB2) receptors (Correct answer)
- Serotonin receptors
Correct answer: Endocannabinoid (CB1 and CB2) receptors
THC (the primary psychoactive compound in cannabis) binds to CB1 receptors in the brain and CB2 receptors in peripheral tissues, mimicking endogenous cannabinoids like anandamide.
Question 5: Compared to opioid withdrawal, alcohol and benzodiazepine withdrawal is considered more dangerous because it can cause:
- Severe diarrhea and dehydration
- Life-threatening seizures and delirium tremens (Correct answer)
- Extreme hypersomnia and respiratory depression
- Profound hypotension requiring hospitalization
Correct answer: Life-threatening seizures and delirium tremens
Alcohol and benzodiazepine withdrawal can produce potentially fatal grand mal seizures and delirium tremens due to CNS hyperexcitability when GABA inhibition is suddenly removed.
Question 6: Which of the following is an FDA-approved pharmacotherapy for treating nicotine dependence?
- Naltrexone
- Disulfiram
- Varenicline (Chantix) (Correct answer)
- Acamprosate
Correct answer: Varenicline (Chantix)
Varenicline is a partial agonist at nicotinic acetylcholine receptors, reducing withdrawal symptoms and blocking nicotine's rewarding effects, making it one of the most effective smoking cessation treatments.
Question 7: The term 'cross-tolerance' means that:
- Two drugs administered together produce additive toxic effects
- Tolerance developed to one drug reduces the effect of a pharmacologically similar drug (Correct answer)
- A drug is effective across multiple diagnoses
- Tolerance disappears when drug use is stopped
Correct answer: Tolerance developed to one drug reduces the effect of a pharmacologically similar drug
Cross-tolerance occurs when tolerance to one substance confers tolerance to another in the same pharmacological class (e.g., tolerance to alcohol reduces the sedative effect of benzodiazepines).
LCDC Pharmacology of Addictions 2
Which statement best distinguishes physical dependence from addiction?