Pharmacology & Substance Use Disorders Flashcards
7 cards from real CARN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Pharmacology & Substance Use Disorders flashcards as text
A patient using methamphetamine presents with severe hyperthermia and agitation. In addition to cooling measures, which medication class is most appropriate for immediate management?
Answer: Benzodiazepines
Benzodiazepines are first-line for methamphetamine-induced agitation and hyperthermia because they reduce CNS excitation without the risks associated with antipsychotics in stimulant toxicity.
Which of the following best describes the pharmacokinetic advantage of the buprenorphine transdermal patch compared to sublingual formulations?
Answer: Avoidance of first-pass metabolism and steady plasma levels
Transdermal buprenorphine bypasses first-pass hepatic metabolism and provides consistent plasma concentrations over days, improving adherence and reducing peak-trough fluctuations.
A nurse notes that a patient's urine drug screen is positive for fentanyl but the patient denies using fentanyl and only admits to heroin use. The most appropriate interpretation is:
Answer: Illicitly obtained heroin is often adulterated with fentanyl, so the result is consistent with the patient's report
Illicit drug supplies, including heroin, are frequently contaminated with fentanyl; a fentanyl-positive screen in a self-reported heroin user is commonly explained by adulteration.
The CARN nurse is reviewing medications for a patient with co-occurring opioid use disorder and major depressive disorder on buprenorphine. Which antidepressant combination requires the most caution due to CYP3A4 interactions?
Answer: Fluoxetine and fluvoxamine
Fluoxetine and fluvoxamine significantly inhibit CYP3A4 and CYP2D6, potentially increasing buprenorphine plasma levels and requiring dose monitoring.
Neonatal opioid withdrawal syndrome (NOWS) is most reliably assessed using which tool?
Answer: Finnegan Neonatal Abstinence Scoring Tool
The Finnegan Neonatal Abstinence Scoring Tool is the standard validated instrument for assessing severity of NOWS and guiding pharmacological treatment decisions.
A patient prescribed naltrexone for alcohol use disorder reports daily opioid pain medication use. The nurse's priority action is to:
Answer: Consult the prescriber before administering because naltrexone will precipitate opioid withdrawal
Naltrexone will precipitate acute opioid withdrawal in a physically dependent patient, so the prescriber must be alerted before administration.
Which pharmacological property of methadone makes it particularly effective for patients who experience opioid-induced hyperalgesia?
Answer: NMDA receptor antagonism in addition to mu-opioid agonism
Methadone's NMDA receptor antagonism helps counter opioid-induced hyperalgesia, a condition where opioid use paradoxically increases pain sensitivity.