Pharmacology and Medication-Assisted Treatment Flashcards

Disulfiram (Antabuse) produces an aversive reaction to alcohol through which primary mechanism?

Answer: Inhibiting aldehyde dehydrogenase, causing toxic acetaldehyde accumulation

Disulfiram inhibits aldehyde dehydrogenase, the enzyme that metabolizes acetaldehyde, causing this toxic metabolite to accumulate and produce flushing, nausea, and cardiovascular distress.

Acamprosate (Campral) is believed to reduce alcohol cravings in early recovery by:

Answer: Modulating glutamate and GABA activity to restore neurochemical balance disrupted by chronic alcohol use

Acamprosate restores the balance between inhibitory GABA and excitatory glutamate neurotransmission disrupted by chronic alcohol use, reducing protracted withdrawal symptoms and cravings.

When managing severe alcohol withdrawal syndrome with a history of seizures, the evidence-based first-line pharmacological treatment is:

Answer: Benzodiazepines such as diazepam or lorazepam

Benzodiazepines are the gold standard for alcohol withdrawal due to cross-tolerance with alcohol at GABA-A receptors, effectively preventing seizures and delirium tremens.

Naltrexone's mechanism of action in treating alcohol use disorder (AUD) involves:

Answer: Blocking opioid receptors to reduce the rewarding effects of alcohol

Naltrexone blocks opioid receptors, disrupting the opioid-mediated dopamine release that contributes to alcohol's rewarding effects, thereby reducing cravings and relapse.

Varenicline (Chantix) is effective for smoking cessation because it:

Answer: Acts as a partial agonist at alpha-4 beta-2 nicotinic receptors, reducing cravings and blocking nicotine's effects

Varenicline is a partial agonist at alpha-4 beta-2 nicotinic acetylcholine receptors, providing enough stimulation to reduce withdrawal while blocking nicotine from fully activating these receptors.

Which smoking cessation medication carries an FDA black box warning due to reports of serious neuropsychiatric adverse effects, including depression and suicidal ideation?

Answer: Varenicline (Chantix)

Varenicline (Chantix) has carried an FDA black box warning for serious neuropsychiatric adverse effects, although subsequent large-scale studies have questioned the magnitude of this risk.

A patient with cocaine use disorder asks about medications to reduce cravings. The clinician should accurately inform the patient that:

Answer: No FDA-approved medications currently exist specifically for stimulant use disorders

As of current evidence, no FDA-approved medications exist specifically for stimulant use disorders (cocaine or methamphetamine), though several candidates are under active investigation.