Pharmacology of Substances Flashcards

Acamprosate (Campral) reduces alcohol craving primarily by modulating:

Answer: GABA and glutamate (NMDA) receptor balance

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

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

Answer: Methadone, used cautiously due to less active metabolite accumulation

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.

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

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

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

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

Answer: Aldehyde dehydrogenase (ALDH), causing acetaldehyde accumulation

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

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

Answer: Naloxone becomes bioavailable intravenously and precipitates withdrawal by blocking opioid receptors

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

Stimulant-induced psychosis most closely resembles which psychiatric condition?

Answer: Paranoid schizophrenia

Stimulant-induced psychosis, characterized by paranoia, auditory hallucinations, and thought disorganization, closely mimics paranoid schizophrenia due to excess dopaminergic activity.

Which benzodiazepine is MOST often recommended for alcohol detoxification because of its long half-life and self-tapering properties?

Answer: Chlordiazepoxide (Librium) or diazepam (Valium)

Long-acting benzodiazepines like chlordiazepoxide and diazepam are preferred for alcohol detox because they provide a smoother, self-tapering withdrawal due to their long half-lives and active metabolites.