MAC Pharmacology of Substances 3

Question 1

Acamprosate (Campral) reduces alcohol craving primarily by modulating:

Accepted Answer

GABA and glutamate (NMDA) receptor balance

Answer

Acamprosate restores the disrupted balance between GABA inhibition and glutamate excitation that occurs during protracted alcohol withdrawal.

Question 2

Which opioid is MOST appropriate for a client with severe renal impairment who requires analgesia and is in OUD recovery?

Accepted Answer

Methadone, used cautiously due to less active metabolite accumulation

Answer

Methadone is often preferred in renal impairment because it has no active metabolites that accumulate; morphine and codeine have renally-cleared active metabolites that can cause toxicity.

Question 3

The 'kindling' phenomenon in alcohol use disorder refers to:

Accepted Answer

Each successive withdrawal episode causing more severe symptoms with lower alcohol intake

Answer

Kindling describes how repeated cycles of alcohol withdrawal cause neuronal sensitization, making subsequent withdrawals progressively more severe and seizure-prone.

Question 4

Disulfiram (Antabuse) produces an aversive reaction to alcohol by inhibiting which enzyme?

Accepted Answer

Aldehyde dehydrogenase (ALDH), causing acetaldehyde accumulation

Answer

Disulfiram inhibits ALDH, causing toxic acetaldehyde to accumulate after alcohol ingestion, producing flushing, nausea, and cardiovascular symptoms.

Question 5

A client on buprenorphine/naloxone (Suboxone) asks why injecting it would be less rewarding than injecting heroin. The counselor explains that this is because:

Accepted Answer

Naloxone becomes bioavailable intravenously and precipitates withdrawal by blocking opioid receptors

Answer

When injected, naloxone becomes systemically active and competitively antagonizes opioid receptors, precipitating acute withdrawal in opioid-dependent individuals.

Master Addiction Counselor Exam Practice Test

Master Addiction Counselor Exam Practice Test

MAC Pharmacology of Substances 3