90 Questions
Which type of drugs are approved for first-line treatment of OCD according to the provided text?
SSRIs
What is the primary action of hallucinogenic drugs such as LSD, mescaline, psilocybin, and MDMA according to the text?
Agonism of 5HT2A receptors
What distinguishes impulsivity from compulsivity according to the text?
Impulsivity is the inability to stop initiating actions & compulsivity is the inability to terminate ongoing actions
Which medication is safe for use in pregnancy according to the provided information?
Buprenorphine, methadone, & heroine
Which medication can be started immediately in the emergency department based on the text?
Benzodiazepines
Which substance primarily acts by agonism of 5HT2A receptors based on the provided information?
MDMA, LSD, mescaline, & psilocybin
Which medication should be avoided in the elderly according to the text?
Buprenorphine & chlordiazepoxedine (librium)
Which medication should not be increased in the elderly based on the information provided?
Benzodiazepines
What is the drug of choice that is a pure antagonist that is used for an emergency opioid overdose?
Naloxone
Why is a series of small doses preferred over 1 large dose of Narcan?
To lessen antagonist-precipitated withdrawal symptoms
When do acute withdrawal symptoms typically present after a naloxone injection?
Within 3 minutes, peaks in 10-20 min, subsiding in 1 hr
Which of the following symptoms is NOT associated with opioid withdrawal?
Drowsiness, fatigue, fever
In what form may naltrexone be provided for clients in the community?
Nasal spray or injection
What role may a psychiatric mental health nurse practitioner (PMHNP) play in relation to naloxone?
Considering providing naloxone prescription for high-risk clients
What is the purpose of Naloxone (Narcan) administration?
To prevent opioid overdose deaths
What class of drug is Naltrexone?
Opioid antagonist
What condition can hallucinogen intoxication lead to, often referred to as a 'bad trip'?
Panic attack
Which medication reduces glutamate release associated with alcohol withdrawal?
Acamprosate
Where do sedative hypnotics act to reduce heavy drinking?
At GABA A receptor sites in reward circuits
What is medication-assisted therapy (MAT) considered for the treatment of opioid use disorder?
First-line therapy
What is defined as the chronic use of opioids that causes clinically significant distress or impairment?
Opioid use disorder
Which impurity is commonly found in opioids sold on the street and poses a significant risk for overdose?
Fentanyl & carfentanyl
In opioid use disorder, what do clients experience when the drug is ceased abruptly?
Withdrawal symptoms
"Impulsive disorders are focused on reward and associated with which pathway mentioned in the text?"
Mesolimbic pathway
Hallucinogenic drugs act of all of the following NTM except?
5HT1A & 5HT1B
Why should Disulfiram not be administered to clients who have recently consumed alcohol?
To avoid a disulfiram reaction
What drug has a long-half life that can prevent withdrawl symptoms for 24 hrs by providing a steady control of cravings throughout the day?
Methadone
What medication is contraindicated for a patient who has already gone through acute withdrawal?
Diazepam
What is the appropriate reversal agent for benzodiazepines (BZOs)?
Romazicon (flumazenil)
Why should Acamprosate not be confused with opiates in its effects?
Because it is used to treat alcohol use disorders
When should Disulfiram be administered to clients with alcohol use disorders?
After their withdrawal symptoms are resolved
What should an expecting mother prescribed medication for heroin use disorder know about breastfeeding?
Babies born to mothers on this medication should not be breastfed
What is the main concern when administering methadone due to its pharmacological properties?
Respiratory depression & QT prolongation
Which setting is permitted to dispense methadone according to the text?
Licensed opioid treatment programs or inpatient hospital units
What is the primary mode of action of morphine in the central nervous system (CNS)?
Inhibiting pain pathways
Which combination can potentially lead to life-threatening outcomes when used with morphine?
Morphine and benzodiazepines
What is a specific indication for morphine use in critically ill patients?
Postoperative pain relief
What factor contributes to the variability in equianalgesic conversion ratios between methadone and other opioids?
Opioid abuse history
What is a common risk associated with methadone conversion in patients with chronic high-dose opiate history?
Seizures
What differentiates the onset of action between immediate-release (IR) and intravenous (IV) administration of morphine?
Onset is slower with IR than IV
What neurotransmitter system does Phentermine block, similar to amphetamine?
Dopamine, norepinephrine, & vesicular monoamine transporter (VMAT)
Which brain region is identified as the control center for appetite?
Hypothalamus
What receptor does Methadone also antagonize, apart from being a full mu-receptor agonist?
NMDA receptor
Why is Benzodiazepine not the first-line treatment for OCD according to the text?
It has minimal impact on serotonin receptors
Which peptide plays a role in appetite stimulation pathways according to the text?
Neuropeptide Y & agouti-related peptide
What is the approved age range for Buprenorphine (Suboxone) use?
< 18 years of age
When can the disulfiram-alcohol reaction occur after alcohol ingestion?
Within 2 weeks of ingestion
Apart from blocking serotonin transporter, what additional action does MDMA have?
Agonizes NMDA receptors & blocks serotonin transporter (SERT)
What is the primary mechanism of disulfiram in the treatment of alcohol use disorders?
Inhibiting aldehyde dehydrogenase
Which drug is significantly more potent compared to morphine?
Fentanyl
In opioid overdose, what is a common sign that indicates respiratory depression?
Blue lips
Which drug can result in a build up of toxic levels of acetaldehyde?
Disulfiram
Which 2 medications are not recommended for breastfeeding mothers due to potential risks?
Naltrexone (Vivitrol) & buprenorphine
Which drug class has a high risk for overdose due to long-term/high doses for pain management, rotating meds of the same class, previous h/o overdose, use of ER, recently released from incarceration, experienced a period of abstinence, or mix with drugs/alcohol.
Opioids
Which situation poses a high risk for opioid overdose based on the provided information?
Recently released from incarceration
What is the key pathway identified as mediating reward in substance use disorder?
Mesolimbic Dopaminergic pathway
Which neurotransmitters' reuptake does Tramadol (an opioid agonist)block, contributing to its mechanism of action?
Serotonin and norepinephrine
What percentage of a client's vulnerability to substance use disorders is attributed to genetic factors?
40-60%
Which brain region is considered a major dopamine-producing area and is associated with motivation and reward?
Ventral tegmental area
Which neurotransmitter pathway connects the ventral tegmental area of the midbrain to the ventral striatum of the basal ganglia?
Mesolimbic Dopamine pathway
What factor influences whether genes associated with substance use disorder are activated?
Epigenetic factors
Which area found within the ventral striatum has a strong association with motivation and reward?
Nucleus accumbens
What is the primary neurotransmitter associated with reward in the brain's mesolimbic pathway?
Dopamine
What adaptation occurs in the brain circuits of individuals with substance use disorder due to increased substance use?
Tolerance to dopamine
Which brain region plays a significant role in impulsive and compulsive behaviors, such as substance use disorder and obsessive-compulsive disorder?
Prefrontal cortex/ striatal circuitry
What happens to dopamine levels in the ventral striatum or nucleus accumbens when addictive drugs are consumed?
There is a surge of dopamine
What medication is used in treating anorexia nervosa?
olanzapine
Which of the following describes the role of dopamine released naturally in response to pleasurable activities such as achieving an accomplishment, enjoying a good meal, or participating in an athletic activity?
It regulates motivation and pleasure
What change in brain circuitry occurs due to repeated use of addictive drugs?
Leads to craving, addiction, and dependence
What term describes the condition following substance ingestion resulting in changes in level of consciousness, cognition, perception, judgment, and behavior?
Intoxication
Which of the following is NOT commonly included as a comorbidity associated with substance use disorders as mentioned in the text?
Schizophrenia & delerium
What does 'tolerance' refer to in the context of substance use according to the text?
Decreased effect of a drug with repeated ingestion
Which age group is more likely to begin alcohol use according to the information provided?
Teenagers
What is the state of adaptation produced with repeated administration of certain drugs that leads to physical symptoms upon abrupt discontinuation?
Dependence
What behavior change is characterized by a biochemical change in the brain following continued substance use despite negative outcomes?
Addiction
What medication is used to treat bulimia?
fluoxetine
What is the primary goal of Medication-Assisted Therapy (MAT) as mentioned in the text?
Improving birth outcomes in substance use during pregnancy
Which neurotransmitters does bupropion primarily enhance according to the text?
Dopamine and nonadrenergic (norepinephrine) release
Which medication is used for symptom-triggered withdrawal regimen according to the text?
Benzodiazepines
What is the primary mechanism of action of varenicline (Chantix) in smoking cessation therapy?
Acting as a nicotine receptor partial agonist
Which drug should be avoided in individuals with anorexia nervosa and bulimia due to its impact on seizure threshold?
bupropoin & ibuprophen
What 2 drugs are not used to treat obesity?
Topiramate & varenicline
What 3 meds are used in treating binge-eating disorders?
lisdexamfetamine, topiramate, & bupropion
MAT substitutes the drug of abuse for prescribed medications. What receptors is best targeted?
The same receptor as the preferred substance
What is the primary goal of Medication-Assisted Therapy (MAT) as mentioned in the text?
Improve treatment retention & survival
Why do binge-eating disorders respond to images of food according to the text?
Due to dopaminergic activity in the right ventral striatum
What risk is associated with tramadol?
Serotonin syndrome
All of the following are important aspects of prescribing varenicline (Chantex) EXCEPT?
Cannot use with other nicotine replacement products
Why may adolescents in community-based substance use disorder treatment programs meet diagnostic criteria for another mental health condition?
Due to dual diagnoses being common in addiction medicine
All of the following are true regarding varenicline (Chantix) EXCEPT?
It can be used in pregnancy
Test your ability to swiftly identify substances taken by a patient based on symptoms in the emergency department. Learn about pupillary responses to illegal substances, the timing to initiate medications, and the distinction between medications requiring immediate administration and those needing gradual withdrawal. Explore medication-associated scenarios in special populations.
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