CADC Alcohol and Drug Counselor Pharmacology of Psychoactive Substances 5 — Questions and Answers
Question 1: Acamprosate (Campral) is believed to help maintain alcohol abstinence by:
- Blocking mu-opioid receptors to reduce pleasurable effects of alcohol
- Restoring balance between GABA and glutamate systems disrupted by chronic alcohol use (Correct answer)
- Inhibiting acetaldehyde dehydrogenase to create an aversive reaction
- Stimulating dopamine release to reduce alcohol cravings directly
Correct answer: Restoring balance between GABA and glutamate systems disrupted by chronic alcohol use
Acamprosate modulates GABA and glutamate neurotransmission, reducing the hyperexcitability that drives protracted withdrawal and relapse risk.
Question 2: Inhalants produce their effects primarily through:
- Stimulating dopamine receptors in the nucleus accumbens
- CNS depression by enhancing GABA activity and inhibiting NMDA receptors (Correct answer)
- Activating serotonin 5-HT3 receptors in the gut-brain axis
- Releasing large amounts of norepinephrine from adrenal glands
Correct answer: CNS depression by enhancing GABA activity and inhibiting NMDA receptors
Inhalants act similarly to alcohol and anesthetics by enhancing GABA activity and inhibiting NMDA glutamate receptors to produce CNS depression.
Question 3: Which of the following is an example of a Schedule II controlled substance?
- Heroin
- Marijuana
- Oxycodone (Correct answer)
- LSD
Correct answer: Oxycodone
Oxycodone is a Schedule II substance, meaning it has high abuse potential but accepted medical use with severe restrictions.
Question 4: A client describes using PCP and experiencing feeling detached from their body and environment. This dissociative effect is due to PCP's action as a:
- Serotonin agonist at 5-HT2A receptors
- NMDA glutamate receptor antagonist (Correct answer)
- GABA-A positive allosteric modulator
- Dopamine D1 receptor partial agonist
Correct answer: NMDA glutamate receptor antagonist
PCP blocks NMDA glutamate receptors, disrupting normal glutamatergic transmission and producing dissociative, anesthetic, and hallucinogenic effects.
Question 5: First-pass metabolism is clinically important because it means that drugs taken orally:
- Are absorbed faster than drugs taken by any other route
- May have significantly reduced bioavailability due to liver metabolism before entering systemic circulation (Correct answer)
- Are safer and cause fewer side effects than injected drugs
- Require a loading dose before therapeutic levels can be achieved
Correct answer: May have significantly reduced bioavailability due to liver metabolism before entering systemic circulation
First-pass metabolism occurs when orally ingested drugs are metabolized in the liver before reaching systemic circulation, reducing their bioavailability.
Question 6: LSD (lysergic acid diethylamide) produces hallucinations primarily by acting as an agonist at:
- Dopamine D4 receptors in the striatum
- Serotonin 5-HT2A receptors in the cerebral cortex (Correct answer)
- GABA-B receptors in the thalamus
- Norepinephrine alpha-1 receptors in the locus coeruleus
Correct answer: Serotonin 5-HT2A receptors in the cerebral cortex
LSD's hallucinogenic effects are primarily mediated through agonist activity at serotonin 5-HT2A receptors in the cortex, disrupting sensory processing.
Question 7: A client who has been drinking heavily for 10 years suddenly stops. The CIWA-Ar scale is used to:
- Measure the amount of alcohol consumed over the past month
- Assess the severity of alcohol withdrawal symptoms to guide treatment (Correct answer)
- Screen for co-occurring mental health disorders during detox
- Determine the appropriate level of care for ongoing addiction treatment
Correct answer: Assess the severity of alcohol withdrawal symptoms to guide treatment
The Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) quantifies alcohol withdrawal symptom severity to guide medical management and medication dosing.
CADC Alcohol and Drug Counselor Pharmacology of Psychoactive Substances 5
Acamprosate (Campral) is believed to help maintain alcohol abstinence by: