CAS CAS Pharmacology & Medication-Assisted Treatment 1 — Questions and Answers
Question 1: Methadone for opioid use disorder (OUD) must be dispensed through a federally certified:
- Outpatient mental health clinic
- Opioid Treatment Program (OTP) (Correct answer)
- Hospital emergency department
- Primary care physician's office
Correct answer: Opioid Treatment Program (OTP)
Federal regulations require that methadone for OUD treatment be dispensed only through DEA-registered and SAMHSA-certified Opioid Treatment Programs.
Question 2: Buprenorphine is classified pharmacologically as a:
- Full opioid agonist
- Partial opioid agonist (Correct answer)
- Opioid antagonist
- Benzodiazepine
Correct answer: Partial opioid agonist
Buprenorphine is a partial opioid agonist, meaning it activates opioid receptors but produces a ceiling effect that limits respiratory depression and abuse potential compared to full agonists.
Question 3: Naloxone is combined with buprenorphine in Suboxone primarily to:
- Enhance the euphoric effect of buprenorphine
- Deter intravenous misuse by precipitating withdrawal if injected (Correct answer)
- Treat co-occurring depression
- Reduce the cost of the medication
Correct answer: Deter intravenous misuse by precipitating withdrawal if injected
When Suboxone is taken sublingually as directed, naloxone has minimal effect, but if injected, naloxone precipitates immediate opioid withdrawal, deterring misuse.
Question 4: Naltrexone (Vivitrol) for OUD works by:
- Partially activating opioid receptors to reduce cravings
- Blocking opioid receptors, preventing opioids from producing euphoria (Correct answer)
- Increasing dopamine in the brain's reward center
- Substituting a safer opioid to reduce withdrawal symptoms
Correct answer: Blocking opioid receptors, preventing opioids from producing euphoria
Naltrexone is a full opioid antagonist that competitively blocks opioid receptors, so if opioids are used, they cannot produce euphoria or reinforcement.
Question 5: Which medication is FDA-approved for alcohol use disorder and works by causing an aversive reaction when alcohol is consumed?
- Naltrexone
- Acamprosate
- Disulfiram (Correct answer)
- Topiramate
Correct answer: Disulfiram
Disulfiram (Antabuse) inhibits aldehyde dehydrogenase, causing accumulation of acetaldehyde when alcohol is ingested, producing flushing, nausea, and palpitations as an aversive deterrent.
Question 6: Acamprosate (Campral) is thought to support alcohol abstinence primarily by:
- Producing nausea when alcohol is consumed
- Restoring the glutamate/GABA balance disrupted by chronic alcohol use (Correct answer)
- Blocking opioid receptors involved in alcohol reward
- Acting as a benzodiazepine substitute during withdrawal
Correct answer: Restoring the glutamate/GABA balance disrupted by chronic alcohol use
Acamprosate modulates glutamatergic and GABAergic neurotransmission, helping to normalize the neurochemical imbalance that drives protracted withdrawal symptoms and craving.
CAS CAS Pharmacology & Medication-Assisted Treatment 1
Methadone for opioid use disorder (OUD) must be dispensed through a federally certified: