Pharmacology and Medication-Assisted Treatment Flashcards

Cross-tolerance between alcohol and benzodiazepines occurs because both substances:

Answer: Primarily enhance GABA-A receptor activity to produce CNS depression

Both alcohol and benzodiazepines enhance GABA-A receptor function, producing CNS depression; tolerance to one substance confers tolerance to the other through shared receptor mechanisms.

The concept of 'pharmacokinetics' in addiction pharmacology primarily refers to:

Answer: How the body absorbs, distributes, metabolizes, and excretes a substance (ADME)

Pharmacokinetics describes what the body does to a drug — encompassing absorption, distribution, metabolism, and excretion — which determines drug concentration at the site of action.

Tolerance to a psychoactive substance is pharmacologically defined as:

Answer: The need for increasing doses to achieve the same effect, or diminished effect with the same dose

Tolerance is defined as requiring higher doses to produce the effect previously achieved at a lower dose, or experiencing diminished effects from the same dose over repeated exposure.

A patient on buprenorphine/naloxone is prescribed a CYP3A4 inhibitor (e.g., ketoconazole) by another provider. The MCAP should be aware this interaction may:

Answer: Increase buprenorphine plasma levels, potentially causing dangerous sedation

CYP3A4 inhibitors reduce buprenorphine metabolism, increasing plasma concentrations and raising the risk of excessive sedation or respiratory depression.

Long-term opioid use produces physical dependence through which primary neuroadaptive mechanism?

Answer: Downregulation of opioid receptors and compensatory upregulation of adenylyl cyclase activity

Chronic opioid exposure causes mu-receptor downregulation and compensatory increases in adenylyl cyclase activity; opioid removal unleashes an unopposed cAMP surge that drives withdrawal symptoms.

When reviewing a client's medication list, an MCAP notes they are taking buprenorphine/naloxone alongside a benzodiazepine prescribed by another provider. The appropriate MCAP response is to:

Answer: Document the combination, educate the client on CNS/respiratory depression risks, and coordinate with prescribers

The MCAP should document the interaction risk, educate the client about the potential for CNS and respiratory depression, and facilitate communication between prescribers — not unilaterally discontinue medications.

The ASAM National Practice Guideline recommends that the duration of medication-assisted treatment (MAT) for opioid use disorder should be:

Answer: Determined individually, with indefinite treatment often appropriate for sustained recovery

ASAM guidelines emphasize individualized, patient-centered treatment duration; indefinite MAT is appropriate for many patients, as premature discontinuation significantly increases overdose and relapse risk.