MCAP Pharmacology and Medication-Assisted Treatment 2

Question 1

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

Accepted Answer

Inhibiting aldehyde dehydrogenase, causing toxic acetaldehyde accumulation

Answer

Blocking dopamine reuptake in the nucleus accumbens

Answer

Antagonizing GABA receptors to counteract alcohol's sedation

Answer

Enhancing glutamate activity to oppose alcohol's depressant effects

Question 2

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

Accepted Answer

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

Answer

Blocking mu-opioid receptors to reduce alcohol's rewarding effects

Answer

Inhibiting aldehyde dehydrogenase to create an aversive reaction to alcohol

Answer

Increasing serotonin release to elevate mood and reduce cravings

Question 3

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

Accepted Answer

Benzodiazepines such as diazepam or lorazepam

Answer

Antipsychotics such as haloperidol

Answer

Beta-blockers such as propranolol

Answer

Opioid agonists such as buprenorphine

Question 4

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

Accepted Answer

Blocking opioid receptors to reduce the rewarding effects of alcohol

Answer

Creating an aversive physical reaction when alcohol is consumed

Answer

Reducing glutamate excitotoxicity associated with alcohol withdrawal

Answer

Increasing dopamine levels to satisfy cravings without alcohol use

Question 5

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

Accepted Answer

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

Answer

Acts as a full agonist at all nicotinic acetylcholine receptors

Answer

Inhibits monoamine oxidase to slow nicotine metabolism and extend its half-life

Answer

Blocks dopamine reuptake to substitute for nicotine's rewarding properties

Question 6

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

Accepted Answer

Varenicline (Chantix)

Answer

Nicotine replacement therapy (transdermal patch)

Answer

Bupropion (Zyban)

Answer

Nortriptyline

Question 7

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

Accepted Answer

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

Answer

Buprenorphine is FDA-approved and highly effective for cocaine use disorder

Answer

Naltrexone completely eliminates cocaine cravings when taken as prescribed

Answer

Disulfiram is the standard first-line medication for cocaine dependence