Pharmacology in Addictions Nursing Flashcards

A patient on methadone maintenance therapy reports severe constipation. Which mechanism best explains this side effect?

Answer: Decreased GI motility due to mu-opioid receptor activation in the gut

Methadone activates mu-opioid receptors in the enteric nervous system, reducing gut motility and causing constipation.

Which medication used in alcohol use disorder works by blocking the reinforcing effects of alcohol through opioid receptor antagonism?

Answer: Naltrexone

Naltrexone is an opioid antagonist that blocks the euphoric and rewarding effects of alcohol by antagonizing mu-opioid receptors.

A nurse is educating a patient starting buprenorphine/naloxone (Suboxone). Which instruction is most critical to prevent precipitated withdrawal?

Answer: Wait until experiencing moderate withdrawal symptoms (COWS score ≥8-12) before taking the first dose

Buprenorphine must not be given until moderate withdrawal is present; its high receptor affinity can displace full agonists and precipitate acute withdrawal.

Which benzodiazepine property makes long-acting agents preferred for managing alcohol withdrawal syndrome?

Answer: Self-tapering effect due to long half-life reducing seizure risk

Long-acting benzodiazepines like diazepam or chlordiazepoxide provide a self-tapering effect, smoothing withdrawal and reducing seizure and delirium risk.

Varenicline (Chantix) aids smoking cessation primarily through which mechanism?

Answer: Partial agonism at alpha-4 beta-2 nicotinic receptors, reducing cravings and blocking nicotine reward

Varenicline acts as a partial agonist at alpha-4 beta-2 nicotinic receptors, providing low-level stimulation to reduce cravings while blocking nicotine's full rewarding effect.

A patient taking disulfiram consumes a small amount of alcohol hidden in a sauce. Which symptom cluster is most expected?

Answer: Flushing, tachycardia, nausea, vomiting, and hypotension

Disulfiram inhibits aldehyde dehydrogenase, causing acetaldehyde accumulation and producing the classic disulfiram-ethanol reaction of flushing, tachycardia, nausea, and hypotension.

Which statement correctly describes acamprosate's mechanism in treating alcohol use disorder?

Answer: It modulates glutamate and GABA activity to reduce post-acute withdrawal symptoms

Acamprosate restores balance between glutamate (excitatory) and GABA (inhibitory) neurotransmission, alleviating protracted abstinence symptoms like anxiety and dysphoria.