NU 578 UNIT 2 EXAM UNIVERSITY OF SOUTH
ALABAMA
NU 578 UNIT 2 EXAM UNIVERSITY OF SOUTH
ALABAMA
NU 578 UNIT 2 EXAM UNIVERSITY OF SOUTH
ALABAMA
EXAM COVERAGE
1. Controlled Substances & DEA Schedules — DEA schedule definitions,
prescribing regulations, refill rules, and federal requirements for Schedule II–V
medications.
,2. Opioid Analgesics & Antagonists — Full agonists, partial agonists, mixed
agonist-antagonists, tramadol, and opioid antagonists including naloxone and
naltrexone.
3. Parkinson's Disease Pharmacotherapy — Levodopa/carbidopa, dopamine
agonists, MAO-B inhibitors, COMT inhibitors, amantadine, and management of
motor fluctuations.
4. Migraine & Headache Management — Triptans, ergotamines, prophylactic
agents including beta-blockers, anticonvulsants, and tricyclic antidepressants.
5. Antipsychotics & Lithium — First-generation vs. second-generation
antipsychotics, extrapyramidal symptoms, tardive dyskinesia, neuroleptic
malignant syndrome, and lithium monitoring.
6. Antidepressants — SSRIs, SNRIs, TCAs, MAOIs, mechanism of action, side
effects, and serotonin syndrome risk.
7. Benzodiazepines & Sedative-Hypnotics — Flumazenil, zolpidem, ramelteon,
barbiturates, and reversal agents.
, 8. CNS Stimulants & ADHD — Methylphenidate formulations, amphetamines,
side effects, and monitoring parameters.
9. Anxiety Disorders — Buspirone, benzodiazepines, and non-controlled
treatment options.
10. Drug Interactions & CYP450 — Warfarin interactions, CYP2C19 and
clopidogrel, and metabolic considerations in special populations.
NU 578 UNIT 2 EXAM UNIVERSITY OF SOUTH
ALABAMA
200 EXAM QUESTIONS WITH ANSWER RATIONALES
Question 1
, A patient currently maintained on buprenorphine/naloxone for opioid use
disorder is scheduled for an upcoming surgical procedure requiring acute pain
management. Which pharmacodynamic property of buprenorphine best explains
why standard full mu-opioid agonist dosing may fail to produce adequate
analgesia in this patient?
A. High intrinsic efficacy at the mu-opioid receptor
B. Partial agonist activity with ceiling effect at the mu-opioid receptor
C. Competitive antagonism at the kappa-opioid receptor
D. Irreversible inhibition of CYP3A4 metabolic pathways
Correct Answer: B
Explanation:
B: Buprenorphine is a partial agonist at the mu-opioid receptor, producing
submaximal effects and demonstrating a ceiling effect on respiratory
depression and analgesia. Because it occupies mu receptors with high affinity
but low intrinsic activity, full agonists like morphine or hydromorphone may be
ALABAMA
NU 578 UNIT 2 EXAM UNIVERSITY OF SOUTH
ALABAMA
NU 578 UNIT 2 EXAM UNIVERSITY OF SOUTH
ALABAMA
EXAM COVERAGE
1. Controlled Substances & DEA Schedules — DEA schedule definitions,
prescribing regulations, refill rules, and federal requirements for Schedule II–V
medications.
,2. Opioid Analgesics & Antagonists — Full agonists, partial agonists, mixed
agonist-antagonists, tramadol, and opioid antagonists including naloxone and
naltrexone.
3. Parkinson's Disease Pharmacotherapy — Levodopa/carbidopa, dopamine
agonists, MAO-B inhibitors, COMT inhibitors, amantadine, and management of
motor fluctuations.
4. Migraine & Headache Management — Triptans, ergotamines, prophylactic
agents including beta-blockers, anticonvulsants, and tricyclic antidepressants.
5. Antipsychotics & Lithium — First-generation vs. second-generation
antipsychotics, extrapyramidal symptoms, tardive dyskinesia, neuroleptic
malignant syndrome, and lithium monitoring.
6. Antidepressants — SSRIs, SNRIs, TCAs, MAOIs, mechanism of action, side
effects, and serotonin syndrome risk.
7. Benzodiazepines & Sedative-Hypnotics — Flumazenil, zolpidem, ramelteon,
barbiturates, and reversal agents.
, 8. CNS Stimulants & ADHD — Methylphenidate formulations, amphetamines,
side effects, and monitoring parameters.
9. Anxiety Disorders — Buspirone, benzodiazepines, and non-controlled
treatment options.
10. Drug Interactions & CYP450 — Warfarin interactions, CYP2C19 and
clopidogrel, and metabolic considerations in special populations.
NU 578 UNIT 2 EXAM UNIVERSITY OF SOUTH
ALABAMA
200 EXAM QUESTIONS WITH ANSWER RATIONALES
Question 1
, A patient currently maintained on buprenorphine/naloxone for opioid use
disorder is scheduled for an upcoming surgical procedure requiring acute pain
management. Which pharmacodynamic property of buprenorphine best explains
why standard full mu-opioid agonist dosing may fail to produce adequate
analgesia in this patient?
A. High intrinsic efficacy at the mu-opioid receptor
B. Partial agonist activity with ceiling effect at the mu-opioid receptor
C. Competitive antagonism at the kappa-opioid receptor
D. Irreversible inhibition of CYP3A4 metabolic pathways
Correct Answer: B
Explanation:
B: Buprenorphine is a partial agonist at the mu-opioid receptor, producing
submaximal effects and demonstrating a ceiling effect on respiratory
depression and analgesia. Because it occupies mu receptors with high affinity
but low intrinsic activity, full agonists like morphine or hydromorphone may be
