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NR547 FINAL EXAM 2025 | A+
GRADED | LATEST VERIFIED Q&A
PACK | ADVANCED
PHARMACOLOGY MASTERY GUIDE|
SHINE AT YOUR OWN COMFORT
Opioid Use Disorder - <> ---Opioids can be ingested orally, snorted intranasally, injected intravenously or subcutaneously
- Symptoms of opioid intoxication:
- euphoric high
- feeling of warmth
- feeling of heavy extremities
- dry mouth
- itchy face
- facial flushing
- period of sedation after the initial euphoria Opioid withdrawal symptoms - <> ---severe muscle cramps & bone aches
- profuse diarrhea
- abdominal cramps
- rhinorrhea
- lacrimation
- piloerection or gooseflesh
- yawning
- fever
- pupillary dilation
- hypertension
- tachycardia
- temperature dysregulation. opioid use disorder Comorbidity - <> --most common comorbid disorders associated with opioid use disorder are other substance use disorders and psychiatric disorders such as mood, antisocial personality, and anxiety disorders
- Users who ingest opioids by injection often have viral (i.e., HIV, hepatitis C virus) and bacterial infections
- also associated with an increased risk for suicide attempts, completed suicides, accidental overdose, and deliberate overdose opioid use disorder Differential Diagnosis - <> ---Opioid-induced mental disorders
- Other substance intoxication (i.e., alcohol, sedative, hypnotic, or anxiolytic)
- Other withdrawal disorders _________________ is the current gold standard in the treatment of opioid use disorder with physiologic dependence for both detoxification and as a maintenance agent - <> --Methadone
- can only be dispensed at an outpatient opioid treatment program _____________ is used to rapidly reverse an opioid overdose - <> --Naloxone
psychotic, anxiety, posttraumatic stress, attention- deficit/hyperactivity, and gambling disorders Stimulant Use Disorder Differential Diagnosis - <> ---primary mental disorders
- phencyclidine (PCP) intoxication
- stimulant intoxication and withdrawal Treatment for stimulant use disorder - <> -- detoxification and psychosocial therapy
- no pharmacologic treatments for symptoms of stimulant withdrawal or to decrease stimulant use Sedative, Hypnotic, or Anxiolytic Use Disorder - <> --most common substances: benzodiazepines, benzodiazepine-like drugs (e.g., zolpidem, zaleplon), carbamates (e.g., glutethimide, meprobamate), barbiturates (e.g., secobarbital), and barbiturate-like hypnotics (e.g., glutethimide, methaqualone), all prescription sleeping medications and almost all prescription antianxiety medications Symptoms of sedative, hypnotic, or anxiolytic intoxication:
- incoordination
- dysarthria
- nystagmus
- impaired memory
- gait disturbance
- severe cases, stupor, coma, or death
Benzodiazepine withdrawal symptoms - <> --anxiety, dysphoria, intolerance for bright lights and loud noises, nausea, sweating, and sometimes seizures Barbiturates and barbiturate-like substance withdrawal symptoms - <> --range from mild symptoms such as anxiety, weakness, sweating, and insomnia to severe symptoms such as seizures, delirium, and death. Treatment and rehabilitation for a person with a sedative, hypnotic, or anxiolytic use disorder - <> --- requires tapering to prevent withdrawal symptoms
- Follow-up treatment, usually with psychiatric help and community support Cannabis Use Disorder - <> --Symptoms of cannabis intoxication:
- a "high," characterized by feelings of mild euphoria, relaxation, and perceptual alterations
- impairment of motor skills, reaction time, motor coordination and psychomotor activity Cannabis withdrawal symptoms - <> -- occur within one to two weeks of cessation:
- irritability
- cravings
- nervousness
- anxiety
- insomnia
- disturbed or vivid dreaming
- decreased appetite
Hallucinogen Use Disorder - <> ---most common hallucinogens: LSD, phenethylamines, and ketamine
- primarily ingested orally, may be smoked, ingested nasally or intravenously
- Symptoms of hallucinogen intoxication: •visual, auditory, and tactile hallucinations
- feeling of separation of oneself from one's body
- pupillary dilation
- tachycardia
- sweating
- palpitations
- blurring of vision
- tremors
- incoordination
- Withdrawal symptoms are not well documented Treatment and rehabilitation for a person with hallucinogen intoxication - <> ---supportive care:
- quiet environment
- verbal reassurance
- the passage of time
- diazepam may be useful for severe anxiety *antipsychotic medications may worsen symptoms
- Most people do not experience physical dependence or withdrawal, but they can develop psychological dependence
Other Use Disorders - <> ---Tobacco Use Disorder
- does not cause behavioral problems
- one of the most prevalent, deadly, and costly substance use disorders
- stimulatory effects to the CNS, while also acting as a skeletal muscle relaxant
- Caffeine Use Disorder
- use can result in psychiatric symptoms and disorders
- associated with five disorders: caffeine intoxication, caffeine withdrawal, caffeine use disorder, caffeine- induced anxiety disorder, and caffeine-induced sleep disorder
- Tx: taper schedule & use analgesics to manage headaches or muscle aches
- Gambling Disorder
- share many features in common with other addictive disorders
- attitude that money is both the cause of and the solution to their problems
- Tx: Psychopharmacological treatment, in addition to group therapy such as Gamblers Anonymous Match the client's symptoms to the most likely toxicology screen results: Joe presents with bloodshot, droopy eyes, and tachycardia. He complains of a dry mouth. Although the clock in his room is working, he has asked several times why the clock keeps stopping.
Match the client's symptoms to the most likely toxicology screen results: Michaela presents with blurry vision. Her balance is impaired, and her eyes display nystagmus. Her speech is also slightly slurred. PCP Methyl enedioxy methamphetamine (MDMA) Cocaine Benzodiazepine Marijuana Heroin - <> --Benzodiazepine Rationale: Symptoms of benzodiazepine intoxication include drowsiness, dizziness, poor balance and coordination, blurry vision, difficulty concentrating, and slurred speech. Match the client's symptoms to the most likely toxicology screen results: Devina presents with aggressive, violent behavior that required physical restraints. She appears to have increased pain tolerance and is having visual hallucinations. She also presents with tachycardia and hypertension. PCP Methyl enedioxy methamphetamine (MDMA) Cocaine Benzodiazepine
Marijuana Heroin - <> --PCP Rationale: Symptoms of PCP intoxication include tachycardia, hypertension, nystagmus, violent behavior, hallucinations, anesthesia, and analgesia. Symptoms may rapidly fluctuate between extreme agitation and sedation. Match the client's symptoms to the most likely toxicology screen results: Joy presents with symptoms of a panic attack. She is visibly sweating and clenching her teeth. She complains of dizziness and stiff muscles. PCP Methyl enedioxy methamphetamine (MDMA) Cocaine Benzodiazepine Marijuana Heroin - <> --Methyl enedioxy methamphetamine (MDMA) Rationale: Symptoms of MDMA intoxication include feelings of panic, depersonalization, illogical thoughts, and physical symptoms including sweating, hot flashes or chills, headache, muscle stiffness, clenching teeth, and dizziness. Match the client's symptoms to the most likely toxicology screen results:
ethical standards to guide making ethical clinical decisions, NAADAC/NCCAP (2021) code of ethics, includes the following principles: - <> ---the counseling relationship
- confidentiality and privileged communication
- professional responsibilities and the workplace standards
- working in a culturally diverse world
- assessment, evaluation, and interpretation
- e-therapy, e-supervision, and social media
- supervision and consultation
- resolving ethical concerns
- publication and communications People receiving MAT are considered to have a _____________ - <> --disability
- because of their record of having an impairment during their substance use
- non-discrimination laws protect individuals with disabilities
- currently using illegal drugs are not protected by federal anti-discrimination laws CAGE - <> --brief 4-question CAGE screening tool for alcoholism/drug abuse Cut down: Have you ever felt the need to cut down on your drinking or drug use? Annoyed: Have you ever been annoyed at criticism of your drinking or drug use?
Guilty: Have you ever felt Guilty about something you've done when you have been drinking or high from drugs? Eye opener: Have you ever had a morning eye opener (taken drugs) first thing in the morning to get going or to avoid withdrawal symptoms? What is the HAM-D? - <> --Clinician administered depression rating scale that monitors the severity of depression symptoms with a focus on psychological and physical aspects of depression (scored 0 - 2 or 0-4). What is the components of the HAM-D? - <> --Mood, guilt feelings, SI, insomnia, work and activities, psychomotor agitation or retardation, anxiety, somatic symptoms, hypochondriasis, loss of weight, insight HAM-D score that indicates no depression? - <> -- 0 - 7 HAM-D score that indicates mild depression? - <> -- 8 - 16 HAM-D score that indicates moderate depression? - <> -- 17 - 23 HAM-D score that indicates severe depression? - <> --24 or >
fatigue, appetite changes, low self-worth, concentrations issues, psychomotor changes, suicidal thoughts What PHQ-9 score indicates none - <> -- 0 - 4 What PHQ-9 score indicates mild - <> -- 5 - 9 What PHQ-9 score indicates moderate - <> -- 10 - 14 What PHQ-9 score indicates moderately severe - <> -- 15 - 19 What PHQ-9 score indicates severe - <> -- 20 - 27 What is the mood disorder questionnaire? - <> --Screening tool used for bipolar disorder that helps to differentiate bipolar from unipolar with 13 yes/no questions What are the components of the mood disorder questionnaire? - <> --Part 1: increased energy and activity, euphoric mood or irritable mood, decreased need for sleep, unusual talkativeness or pressured speech, racing thoughts, easily distracted, increase in goal-directed activities, involvement in risky behaviors, unusual confidence or grandiosity, more outgoing/social than usual, episodes lasting several days or longer, other people noticing these changes, symptoms occurring together in the same time period
Part 2: "Have several of the above symptoms ever happened during the same period of time?" Part 3: "How much did these problems cause difficulty in work, social, or family life?" What is the criteria for the mood disorder questionnaire to be positive? - <> --7 or more "yes" responses in Part 1, "Yes" in Part 2, OR moderate or serious impairment in Part 3 What is the criteria for the mood disorder questionnaire to be negative? - <> --Fewer than 7 "yes" response in Part 1 OR "no" in Part 2 OR "no/minor problems" in Part 3 Normal TSH - <> --0.4-4.0 (elevated TSH = hypo) / (low TSH = hyper) Normal Hgb - <> --Men: 13.8-17.2 / Women: 12.1-15. Normal lithium / toxic - <> --0.6-1.2 / >1. Symptoms of lithium toxicity - <> -- Confusion, seizures, tremors, coma When should a lithium level be drawn? - <> --12 hours after last dose
What is MDD with mood congruent psychosis - <> --Delusions/hallucinations consistent with depressive themes (guilt, worthlessness) What is MDD with mood incongruent psychosis - <> --Psychotic features unrelated to mood (paranoia) What is MDD with anxious distress - <> -- Feeling tense, restless, difficulty concentrating due to worry, fear of losing control
- high risk of suicide and treatment resistance What is MDD with mixed features - <> -- Some manic/hypomanic symptoms present, but not enough for bipolar disorder (increased energy, elevated mood, talkativeness) *Possible bipolar spectrum disorder What is MDD with melancholic features - <> --Severe loss of pleasure (anhedonia), lack of mood reactivity, profound despair/guilt, early morning awakening, significant weight loss, psychomotor agitation/retardation
- more bio in origin, better response to SSRIs or ECT What is MDD with atypical features - <> -- Mood reactivity (can feel better with positive events), increased appetite or weight gain, hypersomnia (excessive sleeping), heaving limb sensations (lead to paralysis), sensitivity to rejection
- often seen in bipolar 2 disorder, respond well to MAOIs What is MDD with catatonia - <> --Mutism, stupor, posturing, rigidity, bizarre movements
- can occur in severe depression, bipolar disorder, or schizphrenia
- requires urgent treatment What is MDD with peripartum onset - <> -- Depression during pregnancy or within 4-week postpartum
- can include psychotic features, risk of postpartum psychosis What is MDD with Seasonal patten (Seasonal Affective Disorder) - <> --Depression occurs in seasonal pattern, typically in fall/winter
- related to light exposure, responds to light therapy What is the diagnostic criteria for Premenstrual Dysphoric Disorder? - <> --Symptoms must occur in the majority of the menstrual cycle Symptoms must be present in the final week before menstruation Symptoms improve within a few days of period onset Symptoms are minimal or absent in the week after menstruation At least 5 symptoms must be present including at lease one in section 1 and one in section 2
