NCMHCE Psychopharmacology and Co-occurring Disorders 3

Question 1

A client with major depression and type 2 diabetes is starting an antidepressant. Which medication warrants the MOST caution due to metabolic side effects?

Accepted Answer

Mirtazapine

Answer

Sertraline

Answer

Bupropion

Answer

Venlafaxine

Question 2

Which benzodiazepine is considered SAFEST for older adults with co-occurring anxiety and alcohol use disorder due to its lack of active metabolites?

Accepted Answer

Lorazepam

Answer

Diazepam

Answer

Chlordiazepoxide

Answer

Clonazepam

Question 3

A client with bipolar I disorder and stimulant use disorder is in a manic episode. Which medication class is CONTRAINDICATED in this situation?

Accepted Answer

Antidepressants as monotherapy

Answer

Atypical antipsychotics

Answer

Mood stabilizers like valproate

Answer

Short-term benzodiazepines for agitation

Question 4

Acamprosate (Campral) is thought to reduce alcohol cravings by acting on which neurotransmitter system?

Accepted Answer

Glutamate/GABA balance

Answer

Dopamine reward pathway

Answer

Opioid mu receptors

Answer

Serotonin 5-HT3 receptors

Question 5

A counselor is reviewing a client's medication list and notices they are taking both an SSRI and tramadol prescribed by their PCP. What risk should the counselor flag?

Accepted Answer

Serotonin syndrome due to dual serotonergic activity

Answer

Reduced analgesic efficacy of tramadol

Answer

Increased risk of SSRI discontinuation syndrome

Answer

Tramadol blocks SSRI absorption

Question 6

Which medication used for alcohol use disorder is an opioid antagonist that works by blocking the reinforcing effects of alcohol?

Accepted Answer

Naltrexone

Answer

Acamprosate

Answer

Disulfiram

Answer

Topiramate

Question 7

A client with depression and chronic pain is prescribed duloxetine. What is the mechanism that makes this medication useful for BOTH conditions?

Accepted Answer

It inhibits serotonin and norepinephrine reuptake, affecting both mood and pain pathways

Answer

It is an opioid receptor partial agonist

Answer

It blocks substance P in the dorsal horn only

Answer

It acts as a GABA-A receptor positive allosteric modulator