Pharmacology and Medication-Assisted Treatment Flashcards

Which medication for opioid use disorder acts as a full mu-opioid agonist and must be dispensed through federally certified opioid treatment programs (OTPs)?

Answer: Methadone

Methadone is a full mu-opioid agonist that, when used for OUD treatment, can only legally be dispensed through federally certified opioid treatment programs.

Buprenorphine exhibits a 'ceiling effect' on respiratory depression primarily because it is a:

Answer: Partial agonist at mu-opioid receptors

Buprenorphine's partial agonist activity at mu-opioid receptors means its respiratory depressant effects plateau, providing a safer margin than full agonists.

Sublingual buprenorphine/naloxone (Suboxone) contains naloxone primarily to:

Answer: Prevent diversion and deter injection misuse

Naloxone is added to deter injection misuse; when injected by an opioid-dependent individual, the bioavailable naloxone precipitates acute withdrawal.

A patient receiving naltrexone for opioid use disorder requires emergency surgery. The surgical team should be informed that:

Answer: Higher-than-usual opioid doses may be needed for adequate pain control

Naltrexone blocks opioid receptors, so patients may require significantly higher opioid doses to achieve adequate analgesia during surgical procedures.

Which of the following represents a contraindication to initiating buprenorphine treatment for opioid use disorder?

Answer: Full opioid agonist use within the past 12-24 hours without signs of withdrawal

Initiating buprenorphine before adequate withdrawal from full opioid agonists risks precipitating acute withdrawal, because buprenorphine's high receptor affinity and partial agonism displace the full agonist.

Extended-release injectable naltrexone (Vivitrol) offers which primary clinical advantage over oral naltrexone for OUD patients?

Answer: Removes the daily adherence requirement, significantly improving medication compliance

Monthly injection eliminates the need for daily pill adherence, which is a major barrier to effective oral naltrexone treatment in real-world settings.

According to evidence-based research, medications for opioid use disorder (MOUD) compared to behavioral therapy alone demonstrate:

Answer: Superior outcomes in reducing illicit opioid use and overdose mortality

Research consistently shows MOUD significantly reduces illicit opioid use, overdose mortality, criminal activity, and infectious disease transmission compared to behavioral therapy alone.