Pharmacology & Substance Use Disorders Flashcards

A patient on methadone maintenance therapy reports QTc prolongation on ECG. What is the most appropriate nursing action?

Answer: Notify the prescriber and monitor for arrhythmias

Methadone can prolong the QTc interval, increasing risk of torsades de pointes, so the prescriber must be notified and cardiac monitoring initiated.

Which benzodiazepine is preferred for alcohol withdrawal management in patients with severe liver disease?

Answer: Lorazepam

Lorazepam (along with oxazepam and temazepam) undergoes direct glucuronidation and is preferred in hepatic impairment because it avoids extensive liver metabolism.

Naltrexone is contraindicated in a patient who:

Answer: Is currently taking opioids for pain management

Naltrexone blocks opioid receptors and will precipitate acute withdrawal in patients physically dependent on opioids.

A patient taking disulfiram consumes a small amount of alcohol in a mouthwash. Which reaction is most likely?

Answer: Mild flushing and tachycardia

Even small amounts of alcohol can trigger a disulfiram-ethanol reaction characterized by flushing, nausea, tachycardia, and hypotension due to acetaldehyde accumulation.

Buprenorphine's 'ceiling effect' on respiratory depression is primarily due to its action as a:

Answer: Partial agonist at mu receptors

Buprenorphine's partial agonist activity at mu-opioid receptors creates a ceiling effect, reducing the risk of fatal respiratory depression compared to full agonists.

Which medication used in opioid use disorder treatment also has FDA approval for alcohol use disorder?

Answer: Naltrexone

Naltrexone is FDA-approved for both opioid use disorder and alcohol use disorder, reducing cravings and the rewarding effects of alcohol.

A nurse is educating a patient about acamprosate for alcohol use disorder. Which statement is most accurate?

Answer: Acamprosate helps reduce cravings by modulating glutamate activity

Acamprosate modulates glutamatergic neurotransmission to reduce protracted withdrawal symptoms and alcohol cravings after abstinence is established.