Final Exam

Question 1

blocks conversion of acetaldehyde to acetic acid, raising acetaldehyde levels 5-10x over ordinary levels when metabolizing alcohol alone.
very effective in preventing alcohol use if taken.
can reduce one’s confidence in ability to abstain.

Answer 1

disulfiram (Antabuse)

Question 2

opioid receptor antagonist.
used to treat alcohol and opioid dependence, but for unknown reasons, is more effective with alcohol.
attenuates euphoric properties of use.
extended release injections, which circumvent adherence problems, cost over $1,200 per month

Answer 2

naltrexone (ReVia, Vivitrol)

Question 3

less potent, longer-acting opioid than heroin.
used for substitution therapy for heroin addiction, and for analgesic effects.
carries abuse potential itself including about 5,000 deaths per year in the US

Answer 3

methadone (Dolophine)

Question 4

less potent, longer-acting opioid than heroin (and methadone).
naloxone (Narcan) is a opioid receptor antagonist.
used for maintenance therapy for heroin addiction, and for analgesic effects.
partial opioid receptor agonist.
carries abuse potential itself and risk of respiratory depression and death, especially if paired with benzodiazapines.
a black market has developed.
longer withdrawal than heroin (up to 1 month)

Answer 4

buprenorphine (Subutex [Suboxone when naloxone is added])

Question 5

partial nicotinic acetylcholine receptor agonist.
releases DA in the NAcc and can therefore reduce nicotine cravings.
potential to increase suicidal ideation; no longer allowed by FAA

Answer 5

varenicline (Chantix, Champix)

Question 6

norepinephrine and DA reuptake inhibitor antidepressant.
increases DA levels in the ventral striatum, reduces cravings, and partially blocks the high associated with nicotine and strong stimulants (cocaine, meth).
no psychoactive properties.
increases blood pressure and lowers seizure threshold; banned in Europe due to hypertensive effects.

Answer 6

bupropion (Wellbutrin, Zyban)

Question 7

for treatment of heroin addiction

Answer 7

methadone (Dolophine)

Question 8

for treatment of opioid addiction

Answer 8

buprenorphine (Subutex [Suboxone when naloxone is added])

Question 9

less potent, longer-acting form of nicotine.
heavily marketed.
intuitive appeal but unsupervised weaning is often ineffective, regardless of the addictive substance.
effectiveness usually assessed by smoking cessation - not addiction to nicotine

Answer 9

nicotine patch

Question 10

partial nicotinic acetylcholine (nACH) receptor agonist.

releases DA in the NAcc and can therefore reduce nicotinic cravings

Answer 10

varenicline (Chantix, Champix)

Question 11

for treatment of alcohol dependence.
glutamate receptor, N-methyl-D-aspartate (NMDA) receptor, and Ca+ channel modulator.
works best with people who are motivated to quit drinking.
FDA label includes warnings about increased suicidal behavior, MDD, and kidney failure.

Answer 11

Acamprosate (Campral)

Question 12

NDRI

Answer 12

bupropion (Wellbutrin, Zyban)

Question 13

defined as any “prospective study comparing the effects and value of interventions against a control in human beings”

Answer 13

clinical trials

Question 14

(which phase of clinical trial)
largely pharmacological studies, examination of drug tolerance, metabolism, drug interactions, pharmacokinetics, and maximum tolerated dose.

Answer 14

Phase I

Question 15

(which phase of clinical trial)

Therapeutic efficacy studies, examination of different doses and measures of outcome.

Answer 15

Phase II

Question 16

(which phase of clinical trial)

Therapeutic confirmation studies, demonstration of clinical use and safety profile.

Answer 16

Phase III

Question 17

(which phase of clinical trial)

Therapeutic use studies, examination of broad and special populations, and identification of uncommon adverse events

Answer 17

Phase IV