Pharmacology & Substance Use Disorders Flashcards

A patient in opioid withdrawal is prescribed clonidine. The nurse understands this medication primarily addresses which symptom cluster?

Answer: Autonomic symptoms such as diaphoresis, tachycardia, and hypertension

Clonidine is an alpha-2 adrenergic agonist that suppresses the noradrenergic hyperactivity driving autonomic symptoms of opioid withdrawal.

Which of the following is a first-line pharmacological treatment for nicotine use disorder that works by partially stimulating nicotinic acetylcholine receptors?

Answer: Varenicline

Varenicline (Chantix) is a partial agonist at alpha-4 beta-2 nicotinic acetylcholine receptors, reducing cravings and blocking the rewarding effects of nicotine.

A patient receiving extended-release naltrexone (Vivitrol) for opioid use disorder requires surgery. The CARN nurse should advise the surgical team that:

Answer: Non-opioid analgesia must be used and opioids will be ineffective at standard doses

Naltrexone blocks opioid receptors, so standard opioid analgesics will be ineffective; non-opioid pain management strategies are preferred and the surgical team must be informed.

Which statement best describes the role of GABA in sedative-hypnotic substance use disorders?

Answer: Alcohol and benzodiazepines enhance GABA-A activity, and chronic use leads to receptor downregulation and tolerance

Alcohol and benzodiazepines potentiate GABA-A inhibitory activity; with chronic use, receptors downregulate causing tolerance, and abrupt cessation causes CNS excitability and withdrawal.

A patient on buprenorphine/naloxone (Suboxone) sublingual film reports nausea and headache after switching to the generic. What is the most likely cause?

Answer: Differences in bioavailability between brand and generic formulations

Minor differences in formulation between brand and generic sublingual films can affect bioavailability, potentially causing mild symptoms until the patient adjusts.

For a pregnant patient with opioid use disorder, which treatment is considered the standard of care?

Answer: Methadone or buprenorphine maintenance therapy

Methadone and buprenorphine maintenance are the evidence-based standards of care for pregnant patients with OUD, reducing fetal risk associated with repeated withdrawal cycles.

Cocaine's primary mechanism of action that produces euphoria involves:

Answer: Blocking reuptake of dopamine, serotonin, and norepinephrine

Cocaine blocks dopamine, norepinephrine, and serotonin transporters, increasing their synaptic concentration, with dopamine elevation in the nucleus accumbens driving euphoria.