NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Drug Name Indication Neurotransmitter(s) Affected Target Symptoms Half-life (T1/2), Metabolism (CYP 450 enzyme) N

NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ Drug Name Indication Neurotransmitter(s) Affected Target Symptoms Half-life (T1/2), Metabolism (CYP 450 enzyme) Notable Side Effects (link to NT or affected brain circuit) Initial Dosing Considerations Specific lifespan considerations (age, pregnancy, breastfeeding) Buprenorphine (Subutex) Indication: • Maintenance treatment of opioid dependence • Maintenance treatment of opioid dependence in patients who have achieved and sustainced Half-life: 24-42 hours CYP450: CYP3A4 • Headache, constipation, nausea • Oral hypoesthesia, glossodynia • Orthostatic hypotension • Implant specific: insertion site pain, pruritis, erythema Initial dosing: Day 1: 8 mg Day 2: 12-16 mg Days 3-7: Increase in increments of 4 mg, maximum 32 mg Considerations: • Use with caution in elderly and those with cardiac impairment NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ prolonged clinical stability on low-tomoderate doses of a transmucosal buprenorphine containing product • Moderate to severe opioid use disorder in patients who have initiated treatment with a transmucosal buprenorphine containing product, followed by dose adjustment for a • Respiratory depression • Hepatotoxicity • May be preferable to methadone in pregnant women • Neonatal withdrawal may occur • Drug is found in breast milk, recommended to DC drug or bottle feed • Safety and efficacy has not been established for children and adolescents. NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ minimum of 7 days Neurotransmitters: • MU opioid receptor partial agonist • Antagonist at the kappa opioid receptor Target symptoms: Opioid dependence Buprenorphine/Naloxone (Suboxone, Zubsolv, Bunavail) Indication: • Induction of treatment for opoid dependence Half-life: Suboxone: 24-42 hours Naloxone: 2-12 hours CYP450: CYP3A4 • Headache, constipation, nausea • Oral hypoesthesia, glossodynia Initial dosing: Bunavail: Day 1: induction dose: Initial: Buccal: Buprenorphine 2.1 mg/naloxone 0.3 mg; may repeat dose after 2 hours, NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ • Maintenance treatment of opioid dependence • Maintenance treatment of opioid dependence in patients who have achieved and sustainced prolonged clinical stability on low-tomoderate doses of a transmucosal buprenorphine containing product • Orthostatic hypotension • Implant specific: insertion site pain, pruritis, erythema • Respiratory depression • Hepatotoxicity based on control of acute withdrawal symptoms; maximum total dose: buprenorphine 4.2 mg/naloxone 0.7 mg. Day 2: induction dose: Up to buprenorphine 8.4 mg/naloxone 1.4 mg as a single dose. Suboxone: Day 1: induction dose: Initial: Sublingual: Buprenorphine 2 mg/naloxone 0.5 mg or buprenorphine 4 mg/naloxone 1 mg; may titrate dose, based on control of acute withdrawal symptoms, in Drug Name Indication Neurotransmitter(s) Affected Target Symptoms Half-life (T1/2), Metabolism (CYP 450 enzyme) Notable Side Effects (link to NT or affected brain circuit) Initial Dosing Considerations Specific lifespan considerations (age, pregnancy, breastfeeding) Buprenorphine (Subutex) Indication: • Maintenance treatment of opioid dependence • Maintenance treatment of opioid dependence in patients who have achieved and sustainced Half-life: 24-42 hours CYP450: CYP3A4 • Headache, constipation, nausea • Oral hypoesthesia, glossodynia • Orthostatic hypotension • Implant specific: insertion site pain, pruritis, erythema Initial dosing: Day 1: 8 mg Day 2: 12-16 mg Days 3-7: Increase in increments of 4 mg, maximum 32 mg Considerations: • Use with caution in elderly and those with cardiac impairment NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ prolonged clinical stability on low-tomoderate doses of a transmucosal buprenorphine containing product • Moderate to severe opioid use disorder in patients who have initiated treatment with a transmucosal buprenorphine containing product, followed by dose adjustment for a • Respiratory depression • Hepatotoxicity • May be preferable to methadone in pregnant women • Neonatal withdrawal may occur • Drug is found in breast milk, recommended to DC drug or bottle feed • Safety and efficacy has not been established for children and adolescents. NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ minimum of 7 days Neurotransmitters: • MU opioid receptor partial agonist • Antagonist at the kappa opioid receptor Target symptoms: Opioid dependence Buprenorphine/Naloxone (Suboxone, Zubsolv, Bunavail) Indication: • Induction of treatment for opoid dependence Half-life: Suboxone: 24-42 hours Naloxone: 2-12 hours CYP450: CYP3A4 • Headache, constipation, nausea • Oral hypoesthesia, glossodynia Initial dosing: Bunavail: Day 1: induction dose: Initial: Buccal: Buprenorphine 2.1 mg/naloxone 0.3 mg; may repeat dose after 2 hours, NR 546 Week 6 Addiction Medication Table QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES (VERIFIED ANSWERS) |ALREADY GRADED A+ • Maintenance treatment of opioid dependence • Maintenance treatment of opioid dependence in patients who have achieved and sustainced prolonged clinical stability on low-tomoderate doses of a transmucosal buprenorphine containing product • Orthostatic hypotension • Implant specific: insertion site pain, pruritis, erythema • Respiratory depression • Hepatotoxicity based on control of acute withdrawal symptoms; maximum total dose: buprenorphine 4.2 mg/naloxone 0.7 mg. Day 2: induction dose: Up to buprenorphine 8.4 mg/naloxone 1.4 mg as a single dose. Suboxone: Day 1: induction dose: Initial: Sublingual: Buprenorphine 2 mg/naloxone 0.5 mg or buprenorphine 4 mg/naloxone 1 mg; may titrate dose, based on control of acute withdrawal symptoms, in