NAECB Medication Management 3

Question 1

A patient taking naltrexone for alcohol use disorder experiences an accidental opioid overdose. Which intervention is most appropriate?

Accepted Answer

Higher doses of naloxone may be needed to overcome naltrexone blockade

Answer

Naltrexone occupies opioid receptors, so higher or repeated naloxone doses may be required to reverse an opioid overdose in patients taking naltrexone.

Question 2

Which of the following best describes the COWS (Clinical Opiate Withdrawal Scale) score range indicating severe opioid withdrawal?

Accepted Answer

Score of 37 or more

Answer

A COWS score of 37 or more indicates severe opioid withdrawal, while scores of 13-24 indicate moderate withdrawal.

Question 3

A pregnant patient with opioid use disorder presents for treatment. Which medication is considered the gold standard for this population?

Accepted Answer

Methadone through an OTP program

Answer

Methadone through an Opioid Treatment Program (OTP) has the most evidence and is considered the gold standard for pregnant patients with OUD, though buprenorphine is also accepted.

Question 4

Which medication interaction requires close monitoring when a patient on methadone maintenance is prescribed rifampin for tuberculosis?

Accepted Answer

Rifampin decreases methadone levels potentially causing withdrawal

Answer

Rifampin is a potent CYP3A4 inducer that significantly decreases methadone plasma levels, which can precipitate opioid withdrawal in patients on maintenance therapy.

Question 5

A patient on buprenorphine/naloxone reports the film is not dissolving properly under the tongue. What is the most likely cause?

Accepted Answer

The patient is not allowing sufficient dissolution time

Answer

Buprenorphine/naloxone films require 5-10 minutes of sublingual dissolution without eating, drinking, or swallowing for proper bioavailability.

NAECB Exam Practice Test

NAECB Exam Practice Test

NAECB Medication Management 3