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Mental Health and Substance Use Disorders Flashcards

7 cards from real BCACP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Mental Health and Substance Use Disorders flashcards as text

  1. A patient with alcohol use disorder (AUD) is started on acamprosate. Which patient population is acamprosate CONTRAINDICATED in?

    Answer: Patients with severe renal impairment (CrCl < 30 mL/min)

    Acamprosate is renally eliminated and is contraindicated in patients with severe renal impairment (CrCl < 30 mL/min), unlike naltrexone which is contraindicated in hepatic failure.

  2. A patient with PTSD is not responding to sertraline. Which medication is the ONLY other FDA-approved pharmacotherapy specifically indicated for PTSD?

    Answer: Paroxetine

    Paroxetine (Paxil) is the only other FDA-approved medication for PTSD besides sertraline; venlafaxine and prazosin are used off-label.

  3. Which stimulant medication for ADHD is classified as Schedule II and requires a new written prescription for each fill with NO refills permitted?

    Answer: Methylphenidate (Ritalin)

    Methylphenidate is a Schedule II controlled substance; federal law prohibits refills, and a new prescription is required for each 30-day supply.

  4. A patient with bipolar depression is initiated on quetiapine. What is the FDA-approved dose range for quetiapine in bipolar depression?

    Answer: 300–600 mg/day

    The FDA-approved dose for quetiapine in bipolar depression is 300–600 mg/day, typically titrated over several days.

  5. A patient taking phenelzine (an MAOI) for treatment-resistant depression requests tramadol for pain. What is the MOST serious risk of this combination?

    Answer: Serotonin syndrome

    Tramadol inhibits serotonin reuptake and combined with an MAOI creates a potentially life-threatening serotonin syndrome.

  6. A pharmacist reviews a prescription for fluoxetine 60 mg/day for a 14-year-old with MDD. Which black box warning must be communicated to the patient and family?

    Answer: Increased risk of suicidal thinking and behavior in pediatric patients

    All antidepressants carry an FDA black box warning for increased risk of suicidal thinking and behavior in children, adolescents, and young adults up to age 24.

  7. A patient with schizophrenia on haloperidol develops sustained muscle contractions of the neck and back. Which agent is FIRST-LINE to rapidly reverse this acute dystonia?

    Answer: Benztropine (Cogentin) IM

    Acute dystonia from antipsychotics is treated with anticholinergic agents such as benztropine or diphenhydramine given IM or IV for rapid reversal.