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Psychopharmacology and Co-occurring Disorders Flashcards

7 cards from real NCMHCE practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

Read the first 7 Psychopharmacology and Co-occurring Disorders flashcards as text

  1. A client with schizophrenia who is treated with clozapine begins using tobacco heavily. What is the PRIMARY clinical concern regarding clozapine levels?

    Answer: Tobacco smoke induces CYP1A2, reducing clozapine blood levels

    Polycyclic aromatic hydrocarbons in tobacco smoke induce CYP1A2 enzymes, which metabolize clozapine, significantly lowering plasma concentrations.

  2. During a clinical assessment, a client reports taking St. John's Wort for depression while also on an SSRI. The counselor's FIRST action should be to:

    Answer: Alert the prescriber due to risk of serotonin syndrome

    St. John's Wort has serotonergic properties, and combining it with an SSRI significantly increases the risk of serotonin syndrome, requiring immediate prescriber notification.

  3. A client with opioid use disorder and ADHD is requesting stimulant medication. What is the MOST evidence-based approach?

    Answer: Use non-stimulant alternatives like atomoxetine or strattera first, or stimulants under close monitoring with MAT

    Non-stimulant medications are preferred first-line for ADHD in those with substance use disorder; stimulants may be used cautiously under close monitoring alongside MAT when benefits outweigh risks.

  4. Which of the following best describes the term 'dual diagnosis' in mental health counseling?

    Answer: The co-occurrence of a mental health disorder and a substance use disorder in the same individual

    Dual diagnosis (also called co-occurring disorders) specifically refers to the simultaneous presence of a mental health disorder and a substance use disorder.

  5. A client with panic disorder and alcohol dependence asks why their panic attacks have worsened since they stopped drinking. What is the BEST explanation?

    Answer: Alcohol withdrawal causes GABAergic rebound and CNS hyperexcitability, exacerbating anxiety

    Alcohol potentiates GABA; withdrawal causes GABA downregulation and glutamate rebound, producing CNS hyperexcitability that manifests as panic and anxiety.

  6. Which mood stabilizer requires regular monitoring of serum levels, thyroid function, and renal function due to its narrow therapeutic index?

    Answer: Lithium

    Lithium has a narrow therapeutic index (0.6–1.2 mEq/L) and requires regular monitoring because toxic levels can cause renal damage, thyroid dysfunction, and neurological impairment.

  7. A counselor is treating a client with co-occurring borderline personality disorder (BPD) and cocaine use disorder. Which psychotherapeutic approach has the STRONGEST evidence base for BPD?

    Answer: Dialectical Behavior Therapy (DBT)

    Dialectical Behavior Therapy (DBT) is the gold-standard evidence-based treatment for borderline personality disorder and also supports emotion regulation in substance use contexts.