NR 547 WEEK 8 2024 QUESTIONS AND ANSWERS
(VERIFIED) 100% CORRECT| A+GRADE
Substance use disorder occurs when: - (answers)the recurrent use of a substance,
such as alcohol or drugs, causes clinically significant impairment
-including health problems, disability, or failure to meet responsibilities at home,
work, or school
Tolerance - (answers)With repeated ingestion of a drug, the drug shows decreased
effect. Increasing doses are required to achieve the effects noted with the original
administration
Dependence - (answers)State of adaptation produced with repeated administration
of certain drugs so that physical symptoms occur when the drug is discontinued
abruptly.
Addiction - (answers)A change in behavior caused by biochemical changes in the
brain after continued substance use characterized by preoccupation with and
repeated use of a substance despite of negative outcomes.
Withdrawal - (answers)Physiological and psychological reactions that occur when
the use of a substance is stopped abruptly.
Intoxication - (answers)Condition following the ingestion of a substance resulting
in changes in level of consciousness, cognition, perception, judgment, and
behavior.
,Bernita is a 64-year-old who has been using heroin for 6 years. She is currently
unemployed and lives with her daughter in the city center. She does not have
health insurance.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - (answers)Methadone
Methadone is a full μ-receptor agonist with a long half-life, which can prevent
withdrawal symptoms for 24 hours and provide steady control of cravings
throughout the day. It is only administered in methadone federally regulated opioid
treatment programs (OTP). Methadone clinics incorporate psychosocial
interventions and require daily attendance for the first several months, so this is a
good option for a client that has the flexibility to attend daily meetings. Use of
methadone in MAT for opioid use disorder helps extend client survival. When
patients stop methadone, they have a high likelihood of relapsing, even 10 years
after starting treatment.
Antoine is a 34-year-old who has been abusing prescription oxycodone. He is
employed but is on probation at work for increased absenteeism. He desires MAT
but is concerned about his roommates stealing his medication to get high.
prescribe the proper medication:
Methadone
Buprenorphine
,Buprenorphine plus naloxone (Suboxone)
Naltrexone - (answers)Buprenorphine plus naloxone (Suboxone)
In combination with naloxone (Suboxone): naloxone is a mu opioid receptor
antagonist and can therefore block the effects of buprenorphine; however, because
naloxone has poor sublingual bioavailability, it does not interfere with
buprenorphine's effects when used properly. Naloxone does have good parenteral
bioavailability; thus, if one tries to administer the buprenorphine/naloxone
formulation intravenously, naloxone will prevent any rewarding effects from
buprenorphine, making this drug a less desirable street drug. Suboxone is a good
option for a client who may not be able to leave work for medication dosing, as it
does not need to be taken under direct observation.
Lisa is a 29-year-old who admits to using "pills, heroin, and booze" regularly. She
lives in a rural area and is employed part-time. She has a history of poor
compliance with past treatments.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - (answers)Naltrexone
Naltrexone blocks mu opioid receptors, preventing exogenous opioids from
binding there and thus preventing the pleasurable effects of opioid consumption.
This medication also reduces alcohol consumption through modulation of opioid
systems, thereby reducing the reinforcing effects of alcohol. For those patients with
alcohol use disorder, who have poor adherence to a regimen, and are unable to
, maintain abstinence, long-acting injection naltrexone (Vivitrol) administered
monthly can be efficacious.
Miranda is a 20-year-old who is 18 weeks pregnant and uses heroin. She wants to
get clean "for her baby."
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone - (answers)Buprenorphine
Buprenorphine is a partial opioid agonist which binds with strong affinity to the
mu opioid receptor, preventing exogenous opioids from binding at the receptor
site, preventing the pleasurable effects of opioid consumption. Buprenorphine is
the recommended MAT for pregnant women who use opioids.
Juan is a 19-year-old who has a history of using oxycodone that he has taken from
his grandfather and drinking occasional alcohol. He wants to stop using both
substances.
prescribe the proper medication:
Bupropion
Chlorpromazine
Disulfiram
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