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1. The term alcohol use disorders (AUDs) refers to a range of alcohol use problems, from intermittent binge drinking, to hazardous drinking, to chronic alcohol abuse and dependence.
A. True
B. False
2. Annual economic costs of AUDs in the United States have been estimated at approximately:
A. $130 billion
B. $155 billion
C. $170 billion
D. $185 billion
3. Medication-assisted treatment combined with brief intervention or more intensive levels of nonpharmacologic treatment for an AUD may do each of the following EXCEPT:
A. Reduce postacute withdrawal symptoms that can lead to a return to drinking
B. Lessen craving and urges to drink or use drugs
C. Be more effective than psychosocial treatment and other interventions
D. Decrease impulsive or situational use of alcohol
4. Long-term, indefinite use of medication for patient stabilization in the treatment of AUDs is not recommended.
A. True
B. False
5. The trade name for the medication acamprosate is:
A. Campral
B. Vivitrol
C. ReVia
D. Rifidin
6. Numerous European trials have found acamprosate significantly more effective than placebo in reducing drinking days, increasing complete abstinence, and:
A. Decreasing cravings
B. Lengthening time to relapse
C. Increasing motivation
D. None of the above
7. Most side effects of acamprosate are mild and transient, lessening or disappearing within the first few weeks of treatment.
A. True
B. False
8. Full effectiveness of acamprosate should be reached within 3-5 days.
A. True
B. False
9. Since acamprosate must be taken four times a day, providers must pay particular attention to patient adherence.
A. True
B. False
10. Disulfiram’s alcohol-aversive effects were first observed in the vulcanized rubber industry in the:
A. 1920s
B. 1930s
C. 1940s
D. 1950s
11. The disulfiram-alcohol reaction usually begins about ____________ minutes after alcohol has been ingested and its adverse effects range from___________________:
A. 20-40 minutes; mild to moderate
B. 10-30 minutes; mild to moderate
C. 20-40 minutes; moderate to severe
D. 10-30 minutes; moderate to severe
12. Disulfiram is most effective for patients who have undergone detoxification or are in the initiation stage of abstinence.
A. True
B. False
13. Which of the following is NOT one of the possible side effects for disulfiram:
A. Anxiety
B. Fatigue
C. Impotence
D. Headache
14. Although disulfiram is not absolutely contraindicated for pregnant or nursing women, it should be avoided because risk to the fetus is unknown.
A. True
B. False
15. Evidence suggests that patients with preexisting liver disease are likely to suffer severe hepatotoxicity from disulfiram therapy.
A. True
B. False
16. Which of the following is NOT a correct statement about disulfiram overdose?
A. Severe cases of disulfiram poisoning have been reported, mostly in children who have accidentally ingested it
B. Symptoms of overdose include severe abdominal pain and yellowing of the eyes or skin
C. Treatment consists of administration of oxygen therapy, glucose, and sodium ascorbate
D. The patient should be kept in bed and as quiet as possible with appropriate symptomatic treatment
17. Mixing disulfiram with benzodiazepines may cause unsteady gait and changes in mental state.
A. True
B. False
18. Patients who may be good candidates for treatment with disulfiram include each of the following EXCEPT:
A. Patients capable of understanding the consequences of drinking alcohol while taking disulfiram
B. Medically appropriate patients who can receive supervised dosing
C. Patients who maintain abstinence during treatment
D. Patients who are codependent on or also abuse marijuana
19. Oral naltrexone has been approved to treat alcohol use disorders since 1994, and has been used to treat ___________________ for many years.
A. Benzodiazepine dependence
B. Cocaine abuse
C. Opioid dependence
D. All of the above
20. Oral naltrexone may be effective in blocking cravings and lessening pleasure received from alcohol.
A. True
B. False
21. FDA labeling recommends that treatment with naltrexone not begin until the patient has between __________ days of abstinence.
A. 1 to 5
B. 2 to 6
C. 3 to 7
D. 4 to 8
22. The most common side effects of oral naltrexone are diarrhea, constipation, difficulty sleeping, and sweating.
A. True
B. False
23. Possible effects of using oral naltrexone with other drugs include:
A. The use of cough/cold medications containing opioids may decrease oral naltrexone benefits
B. The use of yohimbine may result in lethargy and somnolence
C. The use of thioridazine may result in anxiety and increased blood pressure
D. Both A and B above
24. Discontinuation of oral naltrexone is not associated with a withdrawal syndrome, and it is not necessary to taper the dose.
A. True
B. False
25. Unlike oral naltrexone, injectable naltrexone undergoes first-pass metabolism in the liver.
A. True
B. False
26. Treatment with injectable naltrexone should be part of a management program that:
A. Provides patient education
B. Addresses the psychological and social problems of patients
C. Encourages attendance at 12- Step or mutual-help meetings or other community support
D. All of the above
27. Overdose should not be a concern for patients receiving injectable naltrexone because it is unlikely that patients will receive more than three IM injections per month.
A. True
B. False
28. For optimal results with injectable naltrexone, candidates for treatment should meet several criteria including each of the following EXCEPT:
A. They must be medically appropriate to receive naltrexone
B. They should not be using opioids currently or have evidence of recent use
C. They should be motivated to maintain abstinence or to reduce their drinking
D. They should have been abstinent for at least 7 days
29. Possible target patients for injectable naltrexone include those who are unable to maintain medication adherence, and those who would prefer not to have the burden of remembering to take medication daily.
A. True
B. False
30. Pharmacotherapy for alcohol use disorders is underused both in specialized substance abuse treatment programs and in office based-based medical practice.
A. True
B. False
31. Using maintenance medication may provide practitioners with an opportunity to have a significant effect on patients’ overall health status, family relationships, and:
A. Emotional well-being
B. Social functioning
C. Work production
D. None of the above
32. Physiological indicators of alcohol exposure or ingestion which may reflect the presence of an AUD are called:
A. Biomarkers for AUDs
B. Toximarkers for AUDs
C. Hepamarkers for AUDs
D. Systemarkers for AUDs
33. Some symptoms of psychiatric conditions may resolve with abstinence from alcohol, while others may lessen.
A. True
B. False
34. Misuse of opioid medications may complicate detoxification and treatment of AUDs, while abuse of sedatives and tranquilizers may complicate or contraindicate treatment with naltrexone.
A. True
B. False
35. Acamprosate and disulfiram are appropriate to use with which pretreatment indicator?
A. Cognitive impairment
B. Diabetes
C. Chronic pain
D. Coronary artery disease
36. Literature suggests that the medication-psychosocial therapy combination is more effective than either alone for the treatment of AUDs.
A. True
B. False
37. If a patient with an AUD is unwilling to be abstinent, he or she may not be willing to cut down on alcohol use at all, so practitioners should advise the client to come back for treatment when ready to abstain.
A. True
B. False
38. Which of the following is NOT one of the recommended means for monitoring patients’ compliance with treatment plans?
A. Tracking patients' record of keeping (or not keeping) appointments for medication monitoring
B. Periodic client evaluations
C. Monitoring prescriptions refills
D. Noting whether patients are keeping agreements about payment for treatment
39. Important AUD treatment goals are improved personal, social, and work relationships, along with positive changes in physical and emotional health.
A. True
B. False
40. The patient and provider may consider discontinuing medication for an AUD under which of the following circumstances?
A. The patient reports substantially diminished craving
B. The patient has maintained stable abstinence over a sustained period
C. The patient feels ready to discontinue the medication
D. All of the above
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