MH701 Exam 3:
Substance
Abuse,
Pediatrics,
Geriatrics(128
questions and
answers)
What areas of the brain are involved in the
reward pathway? - answer Ventral tegmental
area (VTA)
Nucleus accumbens
Prefrontal cortex
,All drugs that can lead to addiction increase
____ in the ____ - answer Dopamine ; ventral
striatum
Positive rewards are mediated by which
neurotransmitter? - answer Dopamine
Negative rewards are mediated by which
neurotransmitter? - answer GABA
Dopamine release within reward center is
enhanced further by release of natural,
morphine-like neurotransmitters called ____ -
answer Neuropeptides
Describe the reward circuit - answer
Pleasure → dopamine (produced in VTA) →
dopamine sent to amygdala (emotions),
nucleus accumbens (motor functions), PFC
(attention, planning), hippocampus (memory)
Dopamine↑, serotonin↓
,Does medication assisted therapy for opioid
addiciton/alcohol dependence just replace
one drug for another? Why or why not? -
answer No- safe and controlled level of
medication can help reduce withdrawal
symptoms and cravings with no adverse
effects on person's intelligence, mental
capability, physical funcitoning or
employability
What are the 3 opioid dependency
medications? - answer Methadone,
buprenorphine, naltrexone
How long can someone be on MAT? - answer
Months, years, or even a lifetime!
How does methadone work? - answer Mu-
opioid receptor that blocks effects of opioids
while reducing withdrawal symptoms
How is methadone administered? - answer
Orally, once daily
40-60mg usually sufficient to block
withdrawal symptoms
, Higher doses may be needed to block
cravings
Can any provider prescribe methadone? -
answer No- available only through opioid
treatment programs certified through
SAMSHA and DEA
Methadone is most effective with? - answer
Highly dependent patients. Should be
combined with non-pharmacological Rx.
How does buprenorphine work? - answer
Partial mu-opioid agonist that suppresses
cravings and withdrawal symptoms
FDA approved forms of buprenorphine -
answer Sublingual buprenorphine
Sublingual buprenorphine-naloxone tablets
or strips (Suboxone)
Why is the naloxone-buprenorphine combo
used for opioid addiction treatment? - answer
The naloxone component is poorly absorbed
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