CAC Pharmacology and Substance Knowledge 1 — Questions and Answers
Question 1: Which FDA-approved medication for alcohol use disorder works by causing an unpleasant reaction when alcohol is consumed?
- Disulfiram (Antabuse) (Correct answer)
- Naltrexone (Vivitrol)
- Acamprosate (Campral)
- Buprenorphine (Suboxone)
Correct answer: Disulfiram (Antabuse)
Disulfiram inhibits aldehyde dehydrogenase, causing a toxic accumulation of acetaldehyde when alcohol is consumed, producing nausea, flushing, and discomfort.
Question 2: Methadone maintenance treatment for opioid use disorder is dispensed through:
- SAMHSA-certified Opioid Treatment Programs (OTPs) (Correct answer)
- Any licensed pharmacy with a prescription
- Emergency departments only
- Primary care physician offices
Correct answer: SAMHSA-certified Opioid Treatment Programs (OTPs)
Federal law requires that methadone for opioid use disorder be dispensed only through federally certified opioid treatment programs (OTPs), not standard pharmacies.
Question 3: Which class of substances produces withdrawal symptoms that can be life-threatening without medical management?
- Alcohol and benzodiazepines (Correct answer)
- Opioids and stimulants
- Cannabis and hallucinogens
- Opioids and cannabis
Correct answer: Alcohol and benzodiazepines
Alcohol and benzodiazepine withdrawal both involve CNS hyperexcitability that can progress to seizures and death without medical supervision.
Question 4: Buprenorphine (Suboxone) is a partial opioid agonist. What is the clinical significance of the 'ceiling effect'?
- At higher doses, the euphoric and respiratory depression effects plateau, reducing overdose risk (Correct answer)
- The medication stops working after a maximum dose is reached
- Clients cannot become physically dependent on buprenorphine
- Higher doses cause increasingly severe sedation
Correct answer: At higher doses, the euphoric and respiratory depression effects plateau, reducing overdose risk
The ceiling effect means that buprenorphine's opioid effects (including dangerous respiratory depression) do not increase proportionally with higher doses, making it safer than full agonists.
Question 5: Which neurotransmitter is MOST centrally involved in the reward pathway dysregulation that underlies addiction?
- Dopamine (Correct answer)
- Serotonin
- Norepinephrine
- GABA
Correct answer: Dopamine
Dopamine release in the nucleus accumbens (the brain's reward center) is the primary neurochemical mechanism through which addictive substances produce euphoria and reinforce use.
Question 6: Which medication is used to reverse opioid overdose and should be available in addiction treatment settings?
- Naloxone (Narcan) (Correct answer)
- Naltrexone (Vivitrol)
- Flumazenil (Romazicon)
- Acamprosate (Campral)
Correct answer: Naloxone (Narcan)
Naloxone is a pure opioid antagonist that rapidly reverses opioid overdose and is available as a nasal spray (Narcan) for emergency use.
CAC Pharmacology and Substance Knowledge 1
Which FDA-approved medication for alcohol use disorder works by causing an unpleasant reaction when alcohol is consumed?