Week 6 prep for final exam
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Questions and Answers

Which type of drugs are approved for first-line treatment of OCD according to the provided text?

  • Mescaline
  • Benzodiazepines
  • Hallucinogens
  • SSRIs (correct)

    • What is the primary action of hallucinogenic drugs such as LSD, mescaline, psilocybin, and MDMA according to the text?

  • Antagonism of dopamine receptors
  • Agonism of NMDA receptors
  • Agonism of 5HT2A receptors (correct)
  • Agonism of GABA receptors

    • What distinguishes impulsivity from compulsivity according to the text?

  • They both are able to control responses
  • The dorsal striatum is associated with impulsivity & compulsivity is associated with the ventral striatum
  • Both impulsivity & compulsivity are hypothetically neurobiological drives that are "top to bottom"
  • Impulsivity is the inability to stop initiating actions & compulsivity is the inability to terminate ongoing actions (correct)

    • Which medication is safe for use in pregnancy according to the provided information?

    <p>Buprenorphine, methadone, &amp; heroine</p> Signup and view all the answers

    Which medication can be started immediately in the emergency department based on the text?

    <p>Benzodiazepines</p> Signup and view all the answers

    Which substance primarily acts by agonism of 5HT2A receptors based on the provided information?

    <p>MDMA, LSD, mescaline, &amp; psilocybin</p> Signup and view all the answers

    Which medication should be avoided in the elderly according to the text?

    <p>Buprenorphine &amp; chlordiazepoxedine (librium)</p> Signup and view all the answers

    Which medication should not be increased in the elderly based on the information provided?

    <p>Benzodiazepines</p> Signup and view all the answers

    What is the drug of choice that is a pure antagonist that is used for an emergency opioid overdose?

    <p>Naloxone</p> Signup and view all the answers

    Why is a series of small doses preferred over 1 large dose of Narcan?

    <p>To lessen antagonist-precipitated withdrawal symptoms</p> Signup and view all the answers

    When do acute withdrawal symptoms typically present after a naloxone injection?

    <p>Within 3 minutes, peaks in 10-20 min, subsiding in 1 hr</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with opioid withdrawal?

    <p>Drowsiness, fatigue, fever</p> Signup and view all the answers

    In what form may naltrexone be provided for clients in the community?

    <p>Nasal spray or injection</p> Signup and view all the answers

    What role may a psychiatric mental health nurse practitioner (PMHNP) play in relation to naloxone?

    <p>Considering providing naloxone prescription for high-risk clients</p> Signup and view all the answers

    What is the purpose of Naloxone (Narcan) administration?

    <p>To prevent opioid overdose deaths</p> Signup and view all the answers

    What class of drug is Naltrexone?

    <p>Opioid antagonist</p> Signup and view all the answers

    What condition can hallucinogen intoxication lead to, often referred to as a 'bad trip'?

    <p>Panic attack</p> Signup and view all the answers

    Which medication reduces glutamate release associated with alcohol withdrawal?

    <p>Acamprosate</p> Signup and view all the answers

    Where do sedative hypnotics act to reduce heavy drinking?

    <p>At GABA A receptor sites in reward circuits</p> Signup and view all the answers

    What is medication-assisted therapy (MAT) considered for the treatment of opioid use disorder?

    <p>First-line therapy</p> Signup and view all the answers

    What is defined as the chronic use of opioids that causes clinically significant distress or impairment?

    <p>Opioid use disorder</p> Signup and view all the answers

    Which impurity is commonly found in opioids sold on the street and poses a significant risk for overdose?

    <p>Fentanyl &amp; carfentanyl</p> Signup and view all the answers

    In opioid use disorder, what do clients experience when the drug is ceased abruptly?

    <p>Withdrawal symptoms</p> Signup and view all the answers

    "Impulsive disorders are focused on reward and associated with which pathway mentioned in the text?"

    <p><strong>Mesolimbic</strong> pathway</p> Signup and view all the answers

    Hallucinogenic drugs act of all of the following NTM except?

    <p>5HT1A &amp; 5HT1B</p> Signup and view all the answers

    Why should Disulfiram not be administered to clients who have recently consumed alcohol?

    <p>To avoid a disulfiram reaction</p> Signup and view all the answers

    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?

    <p>Methadone</p> Signup and view all the answers

    What medication is contraindicated for a patient who has already gone through acute withdrawal?

    <p>Diazepam</p> Signup and view all the answers

    What is the appropriate reversal agent for benzodiazepines (BZOs)?

    <p>Romazicon (flumazenil)</p> Signup and view all the answers

    Why should Acamprosate not be confused with opiates in its effects?

    <p>Because it is used to treat alcohol use disorders</p> Signup and view all the answers

    When should Disulfiram be administered to clients with alcohol use disorders?

    <p>After their withdrawal symptoms are resolved</p> Signup and view all the answers

    What should an expecting mother prescribed medication for heroin use disorder know about breastfeeding?

    <p>Babies born to mothers on this medication should not be breastfed</p> Signup and view all the answers

    What is the main concern when administering methadone due to its pharmacological properties?

    <p>Respiratory depression &amp; QT prolongation</p> Signup and view all the answers

    Which setting is permitted to dispense methadone according to the text?

    <p>Licensed opioid treatment programs or inpatient hospital units</p> Signup and view all the answers

    What is the primary mode of action of morphine in the central nervous system (CNS)?

    <p>Inhibiting pain pathways</p> Signup and view all the answers

    Which combination can potentially lead to life-threatening outcomes when used with morphine?

    <p>Morphine and benzodiazepines</p> Signup and view all the answers

    What is a specific indication for morphine use in critically ill patients?

    <p>Postoperative pain relief</p> Signup and view all the answers

    What factor contributes to the variability in equianalgesic conversion ratios between methadone and other opioids?

    <p>Opioid abuse history</p> Signup and view all the answers

    What is a common risk associated with methadone conversion in patients with chronic high-dose opiate history?

    <p>Seizures</p> Signup and view all the answers

    What differentiates the onset of action between immediate-release (IR) and intravenous (IV) administration of morphine?

    <p>Onset is slower with IR than IV</p> Signup and view all the answers

    What neurotransmitter system does Phentermine block, similar to amphetamine?

    <p>Dopamine, norepinephrine, &amp; vesicular monoamine transporter (VMAT)</p> Signup and view all the answers

    Which brain region is identified as the control center for appetite?

    <p>Hypothalamus</p> Signup and view all the answers

    What receptor does Methadone also antagonize, apart from being a full mu-receptor agonist?

    <p>NMDA receptor</p> Signup and view all the answers

    Why is Benzodiazepine not the first-line treatment for OCD according to the text?

    <p>It has minimal impact on serotonin receptors</p> Signup and view all the answers

    Which peptide plays a role in appetite stimulation pathways according to the text?

    <p>Neuropeptide Y &amp; agouti-related peptide</p> Signup and view all the answers

    What is the approved age range for Buprenorphine (Suboxone) use?

    <p>&lt; 18 years of age</p> Signup and view all the answers

    When can the disulfiram-alcohol reaction occur after alcohol ingestion?

    <p>Within 2 weeks of ingestion</p> Signup and view all the answers

    Apart from blocking serotonin transporter, what additional action does MDMA have?

    <p>Agonizes NMDA receptors &amp; blocks serotonin transporter (SERT)</p> Signup and view all the answers

    What is the primary mechanism of disulfiram in the treatment of alcohol use disorders?

    <p>Inhibiting aldehyde dehydrogenase</p> Signup and view all the answers

    Which drug is significantly more potent compared to morphine?

    <p>Fentanyl</p> Signup and view all the answers

    In opioid overdose, what is a common sign that indicates respiratory depression?

    <p>Blue lips</p> Signup and view all the answers

    Which drug can result in a build up of toxic levels of acetaldehyde?

    <p>Disulfiram</p> Signup and view all the answers

    Which 2 medications are not recommended for breastfeeding mothers due to potential risks?

    <p>Naltrexone (Vivitrol) &amp; buprenorphine</p> Signup and view all the answers

    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.

    <p>Opioids</p> Signup and view all the answers

    Which situation poses a high risk for opioid overdose based on the provided information?

    <p>Recently released from incarceration</p> Signup and view all the answers

    What is the key pathway identified as mediating reward in substance use disorder?

    <p>Mesolimbic Dopaminergic pathway</p> Signup and view all the answers

    Which neurotransmitters' reuptake does Tramadol (an opioid agonist)block, contributing to its mechanism of action?

    <p>Serotonin and norepinephrine</p> Signup and view all the answers

    What percentage of a client's vulnerability to substance use disorders is attributed to genetic factors?

    <p>40-60%</p> Signup and view all the answers

    Which brain region is considered a major dopamine-producing area and is associated with motivation and reward?

    <p>Ventral tegmental area</p> Signup and view all the answers

    Which neurotransmitter pathway connects the ventral tegmental area of the midbrain to the ventral striatum of the basal ganglia?

    <p>Mesolimbic Dopamine pathway</p> Signup and view all the answers

    What factor influences whether genes associated with substance use disorder are activated?

    <p>Epigenetic factors</p> Signup and view all the answers

    Which area found within the ventral striatum has a strong association with motivation and reward?

    <p>Nucleus accumbens</p> Signup and view all the answers

    What is the primary neurotransmitter associated with reward in the brain's mesolimbic pathway?

    <p>Dopamine</p> Signup and view all the answers

    What adaptation occurs in the brain circuits of individuals with substance use disorder due to increased substance use?

    <p>Tolerance to dopamine</p> Signup and view all the answers

    Which brain region plays a significant role in impulsive and compulsive behaviors, such as substance use disorder and obsessive-compulsive disorder?

    <p>Prefrontal cortex/ striatal circuitry</p> Signup and view all the answers

    What happens to dopamine levels in the ventral striatum or nucleus accumbens when addictive drugs are consumed?

    <p>There is a surge of dopamine</p> Signup and view all the answers

    What medication is used in treating anorexia nervosa?

    <p>olanzapine</p> Signup and view all the answers

    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?

    <p>It regulates motivation and pleasure</p> Signup and view all the answers

    What change in brain circuitry occurs due to repeated use of addictive drugs?

    <p>Leads to craving, addiction, and dependence</p> Signup and view all the answers

    What term describes the condition following substance ingestion resulting in changes in level of consciousness, cognition, perception, judgment, and behavior?

    <p>Intoxication</p> Signup and view all the answers

    Which of the following is NOT commonly included as a comorbidity associated with substance use disorders as mentioned in the text?

    <p>Schizophrenia &amp; delerium</p> Signup and view all the answers

    What does 'tolerance' refer to in the context of substance use according to the text?

    <p>Decreased effect of a drug with repeated ingestion</p> Signup and view all the answers

    Which age group is more likely to begin alcohol use according to the information provided?

    <p>Teenagers</p> Signup and view all the answers

    What is the state of adaptation produced with repeated administration of certain drugs that leads to physical symptoms upon abrupt discontinuation?

    <p>Dependence</p> Signup and view all the answers

    What behavior change is characterized by a biochemical change in the brain following continued substance use despite negative outcomes?

    <p>Addiction</p> Signup and view all the answers

    What medication is used to treat bulimia?

    <p>fluoxetine</p> Signup and view all the answers

    What is the primary goal of Medication-Assisted Therapy (MAT) as mentioned in the text?

    <p>Improving birth outcomes in substance use during pregnancy</p> Signup and view all the answers

    Which neurotransmitters does bupropion primarily enhance according to the text?

    <p>Dopamine and nonadrenergic (norepinephrine) release</p> Signup and view all the answers

    Which medication is used for symptom-triggered withdrawal regimen according to the text?

    <p>Benzodiazepines</p> Signup and view all the answers

    What is the primary mechanism of action of varenicline (Chantix) in smoking cessation therapy?

    <p>Acting as a nicotine receptor partial agonist</p> Signup and view all the answers

    Which drug should be avoided in individuals with anorexia nervosa and bulimia due to its impact on seizure threshold?

    <p>bupropoin &amp; ibuprophen</p> Signup and view all the answers

    What 2 drugs are not used to treat obesity?

    <p>Topiramate &amp; varenicline</p> Signup and view all the answers

    What 3 meds are used in treating binge-eating disorders?

    <p>lisdexamfetamine, topiramate, &amp; bupropion</p> Signup and view all the answers

    MAT substitutes the drug of abuse for prescribed medications. What receptors is best targeted?

    <p>The same receptor as the preferred substance</p> Signup and view all the answers

    What is the primary goal of Medication-Assisted Therapy (MAT) as mentioned in the text?

    <p>Improve treatment retention &amp; survival</p> Signup and view all the answers

    Why do binge-eating disorders respond to images of food according to the text?

    <p>Due to dopaminergic activity in the right ventral striatum</p> Signup and view all the answers

    What risk is associated with tramadol?

    <p>Serotonin syndrome</p> Signup and view all the answers

    All of the following are important aspects of prescribing varenicline (Chantex) EXCEPT?

    <p>Cannot use with other nicotine replacement products</p> Signup and view all the answers

    Why may adolescents in community-based substance use disorder treatment programs meet diagnostic criteria for another mental health condition?

    <p>Due to dual diagnoses being common in addiction medicine</p> Signup and view all the answers

    All of the following are true regarding varenicline (Chantix) EXCEPT?

    <p>It can be used in pregnancy</p> Signup and view all the answers

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