QUESTIONS AND ANSWERS (VERIFIED)
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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 Correct Answer 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 Correct Answer 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 Correct Answer 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 Correct Answer 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
Methadone
Naloxone
Naltrexone
Varenicline Correct Answer Naltrexone
Naltrexone is a good option for clients who use opioids and
alcohol and are committed to abstinence.