Pharmacology in Addictions Nursing Flashcards

Which of the following correctly describes the pharmacokinetic advantage of methadone in treating opioid use disorder?

Answer: Long half-life (24–36 hours) enables once-daily dosing and prevents withdrawal between doses

Methadone's long half-life of 24–36 hours allows once-daily dosing, maintains stable blood levels, and prevents the peaks and troughs that drive craving.

A patient with opioid use disorder is starting naltrexone. The nurse knows the patient must be opioid-free for at least how long before initiation to prevent precipitated withdrawal?

Answer: 7–10 days for short-acting opioids; 10–14 days for methadone

Naltrexone should not be initiated until the patient is opioid-free for 7–10 days (short-acting) or 10–14 days (methadone) to avoid precipitating severe withdrawal.

Nicotine replacement therapy (NRT) reduces withdrawal symptoms primarily by:

Answer: Providing controlled nicotine delivery to reduce withdrawal without behavioral reinforcement of smoking

NRT delivers nicotine in controlled doses to reduce withdrawal symptoms and cravings while eliminating tobacco combustion products and the behavioral ritual of smoking.

A patient on methadone maintenance is prescribed erythromycin for an infection. The nurse's priority concern is:

Answer: QTc interval prolongation increasing risk of torsades de pointes

Both methadone and erythromycin can prolong the QTc interval, and their combination significantly increases risk of life-threatening torsades de pointes.

Which statement about buprenorphine's ceiling effect is clinically most significant?

Answer: At higher doses, increasing buprenorphine does not proportionally increase respiratory depression, reducing overdose risk

As a partial agonist, buprenorphine's respiratory depression effect plateaus at higher doses, making overdose from buprenorphine alone far less likely than with full opioid agonists.

A patient with alcohol use disorder has been abstinent for 6 months and wants to stop taking acamprosate. The nurse should advise:

Answer: Continue for at least 12 months total as relapse risk remains elevated, then discuss with provider

Guidelines recommend acamprosate for at least 12 months to address prolonged post-acute withdrawal; stopping early increases relapse risk since neurochemical dysregulation can persist.

Which pharmacological property of fentanyl makes it particularly dangerous compared to heroin in the context of overdose?

Answer: Extreme potency (50–100x morphine) leading to rapid, unpredictable respiratory depression at minute quantities

Fentanyl's extreme potency means that microgram quantities can cause fatal respiratory depression, and illicit supply inconsistency makes every dose potentially lethal.