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1. Peak buprenorphine plasma concentrations occur 12 hours after implant insertion, slowly decrease, and reach steady-state concentrations in about:
A. 24 hours
B. 4 to 6 days
C. 4 weeks
D. 4 to 6 months
2. After providing the first dose of buprenorphine, wait at least _____ to decide whether a second dose is necessary.
A. 30 minutes
B. 2 hours
C. 8 hours
D. 24 hours
3. Both buprenorphine and naloxone are bioavailable in transmucosal products, thereby allowing naloxone to blunt the immediate opioid agonist effects of buprenorphine, when taken:
A. Intranasally or intravenously
B. As prescribed
C. Intranasally, intravenously, and as prescribed
D. Buprenorphine and naloxone are not both bioavailable at the same time
4. Subdermal buprenorphine implants release buprenorphine in steady concentrations over 6 months approximately equivalent to _____ of the buprenorphine sublingual formulations.
A. 16 mg
B. 12 mg
C. 8 mg
D. 4 mg
5. Misuse and diversion of buprenorphine can be discouraged by:
A. Requiring frequent office visits until patients are stable.
B. Testing urine for buprenorphine and norbuprenorphine or buprenorphine glucuronide.
C. Using other methods to ensure adequate adherence to the medication as prescribed, such as developing and adopting a diversion control plan.
D. Misuse and diversion can be discouraged by requiring frequent office visits, testing urine, and adopting a diversion control plan.
6. Patients will develop physical dependence on buprenorphine and should be alerted that they will experience opioid withdrawal if they stop buprenorphine.
A. True
B. False
7. Research has shown that the dose of opioid agonist medication is directly related to the severity of neonatal abstinence syndrome and pregnant women should therefore be on the lowest dose of medication necessary.
A. True
B. False
8. In animal reproductive studies with Sublocade’s excipient, there have been reported fetal adverse reactions.
A. True
B. False
9. Before buprenorphine is prescribed, all of the following laboratory tests should be conducted, except for:
A. Pregnancy test
B. Liver function test
C. Renal function test
D. Hepatitis and HIV tests
10. Prior use of diverted buprenorphine rules out OUD treatment with buprenorphine.
A. True
B. False
11. Unsuccessful treatment experiences with buprenorphine in the past indicated that buprenorphine will be ineffective if tried again.
A. True
B. False
12. Pregnant women should be considered for transmucosal buprenorphine treatment.
A. True
B. False
13. Buprenorphine implants are indicated for patients who have already achieved illicit opioid abstinence and clinical stability while taking transmucosal buprenorphine for at least:
A. 120 days
B. 90 days
C. 60 days
D. 30 days
14. Clinical experience indicates that patients suitable for home induction can:
A. Describe, understand, and rate withdrawal.
B. Understand induction dosing instructions.
C. And will contact their provider about problems.
D. Patients suitable for home induction can describe, understand, and rate withdrawal, understand induction dosing instructions, and will contact their provider about problems.
15. Withdrawal can include all of the following, except:
A. Constipation
B. Running nose
C. Goose bumps
D. Yawning
16. Nicotine causes vasoconstriction, decreasing the surface area of blood vessels that absorb buprenorphine, therefore, patients should be advised to abstain from tobacco before dosing.
A. True
B. False
17. Nearly all patients stabilize on daily doses of 4 mg/1 mg to:
A. 8 mg/2 mg
B. 16 mg/4 mg
C. 20 mg/5 mg
D. 24 mg/6 mg
18. An effective maintenance dose is the lowest dose that can:
A. Eliminate withdrawal
B. Reduce or eliminate opioid cravings
C. Reduce or stop illicit opioid use’s desirable effects
D. An effective maintenance dose is the lowest dose that eliminates withdrawal, reduces or eliminates opioid craving, reduces or stops illicit opioid use’s desirable effects, and is a dose that can be well tolerated
19. Gauge treatment progress and success based on:
A. The patients’ achievement of specific goals that were agreed on in a shared decision-making and treatment planning process.
B. The amount of medication a patient needs.
C. How long treatment is required.
D. Treatment progress and success should be gauged by the amount of medication a patient needs, how long treatment is required, and the achievement of specific goals that were agreed on.
20. It is up to patients to decide whether to taper or eventually discontinue medication.
A. True
B. False
21. Overdose death with buprenorphine is most often associated with intravenous benzodiazepine and heavy alcohol use.
A. True
B. False
22. Initiation of HIV or hepatitis C virus treatments contraindicate buprenorphine treatment.
A. True
B. False
23. Prescribers of _____ must be able to refer patients for appropriate adjunctive counseling and ancillary services as needed according to federal law.
A. Naltrexone
B. Buprenorphine
C. Both naltrexone and buprenorphine
D. Neither naltrexone nor buprenorphine
24. Some peer recovery support groups consider patients taking methadone and buprenorphine for OUD treatment as not being abstinent from opioids, and groups not accepting of OUD medications are not appropriate for patients taking them.
A. True
B. False
25. All of the following are indications that a patient is ready to come less than weekly for visits, except for:
A. Adherence to appointments and treatment plan.
B. No ongoing drug use that may risk patient safety.
C. Several months of illicit opioid abstinence based on self-report.
D. Absence of significant mediation side effects.
26. Buprenorphine implants are indicated only for patients treated with transmucosal buprenorphine for at least 1 week.
A. True
B. False
27. Ongoing clinical monitoring that includes drug testing of urine or oral fluid specimens is part of good practice.
A. True
B. False
28. Which of the following is the key to effective patient management in general hospital settings?
A. Balancing pharmacotherapy for OUD with other medical concerns.
B. Careful management after discharge.
C. Seamless transfer to opioid treatment.
D. Balancing pharmacotherapy for OUD with other medical concerns, careful management after discharge, and seamless transfer to opioid treatment are all keys to effective patient management in general hospital settings.
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