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 with alcohol use disorder is started on gabapentin. What is the primary evidence-based rationale for this medication in this context?
Answer: It reduces alcohol craving and withdrawal symptoms by modulating calcium channels and glutamate
Gabapentin modulates voltage-gated calcium channels and reduces glutamate activity, helping manage protracted withdrawal symptoms and cravings, though it is not FDA-approved for AUD.
The nurse is administering IV lorazepam to a patient in severe alcohol withdrawal. Which complication specific to IV lorazepam requires close monitoring?
Answer: Propylene glycol toxicity with high cumulative doses
IV lorazepam formulations contain propylene glycol as a solvent, and high cumulative doses can cause propylene glycol toxicity including metabolic acidosis and renal injury.
A patient reports using kratom daily to self-manage opioid cravings. The CARN nurse should recognize that kratom:
Answer: Contains alkaloids that act on opioid receptors and can cause dependence and withdrawal
Kratom contains mitragynine and 7-hydroxymitragynine, which bind opioid receptors; regular use can cause opioid-type dependence and withdrawal syndrome.
Which statement about the pharmacology of cannabis is accurate regarding its effect on the endocannabinoid system?
Answer: THC mimics endocannabinoids by acting as a CB1 and CB2 receptor partial agonist
THC acts as a partial agonist at CB1 (primarily CNS) and CB2 (primarily immune) receptors, mimicking endocannabinoids like anandamide to produce psychoactive and physiological effects.
A patient with opioid use disorder on stable buprenorphine/naloxone is prescribed rifampin for tuberculosis. The nurse anticipates which medication adjustment?
Answer: Increasing buprenorphine dose because rifampin strongly induces CYP3A4, lowering buprenorphine levels
Rifampin is a potent CYP3A4 inducer that significantly reduces buprenorphine plasma concentrations, often requiring a dose increase to maintain therapeutic effect.
Gamma-hydroxybutyrate (GHB) withdrawal is most similar in presentation and management to withdrawal from which substance?
Answer: Sedative-hypnotics such as alcohol and benzodiazepines
GHB acts on GABA-B receptors and GHB receptors; withdrawal produces CNS hyperexcitability similar to alcohol and benzodiazepine withdrawal, including seizures and delirium.
A nurse is counseling a patient about naloxone home use. Which instruction is most important regarding repeat dosing?
Answer: Naloxone's duration of action may be shorter than the opioid's, requiring repeat doses every 2-3 minutes if the patient does not respond
Naloxone's duration of action (30-90 minutes) is often shorter than many opioids, so repeat dosing every 2-3 minutes may be necessary, and emergency services must always be called.