ADVANCED PSYCHOPHARMACOLOGY NR
546 EXAM SCRIPT FINAL PAPER 2026
SOLVED QUESTION SET GRADED A+
◉SCENARIO: Nori is a 24-year-old who has a history of abusing
opioid medications and binge drinking. She is not committed to
abstain from using at this time.. Answer: MAT: naloxone
RATIONALE: Since Nori is not committed to abstaining at this time,
it is important to provide naloxone along with education to help her
remain safe from overdose.
◉SCENARIO: 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.. Answer:
MAT: naltrexone
RATIONALE:Naltrexone is a good option for clients who use opioids
and alcohol and are committed to abstinence
◉Pregnancy with Buprenorphine. Answer: Buprenorphine is an
acceptable treatment during pregnancy; however, there is an
increased risk of a neonatal withdrawal syndrome in newborns.
,◉Pregnancy with Suboxone (buprenorphine/naloxone). Answer:
Suboxone (buprenorphine/naloxone) cannot be used in pregnancy
◉Pregnancy with Naloxone. Answer: Naloxone increases the risk of
neonatal abstinence syndrome. Pregnant clients must be switched to
buprenorphine (Subutex) monotherapy.
◉Pregnancy with Methadone. Answer: Methadone is approved in
pregnancy for heroin-addicted women. Dosing requires adjustment.
◉Pregnancy in MAT. Answer: Short-term newborn withdrawal
effects may be seen and may require neonatal intensive care unit
(NICU) admission for treatment.
◉Breast Feeding with Naltrexone and Buprenorphine. Answer: Not
recommended
◉Breast Feeding with Methadone. Answer: Can be prescribed with
special consideration given to feeding intervals (breastfeed prior to
or 2-6 hours after dose).
◉Older Adult with Buprenorphine. Answer: Use in the elderly may
lead to confusion and drowsiness
,◉Older Adult with Methadone. Answer: Methadone has a high
potential for drug interactions, associated with QT prolongation.
It is difficult to titrate in the elderly and has a risk for accumulation
due to the long half-life
◉MAT for Chronic Alcohol Use Disorder. Answer: Medication
selections for MAT should be based on clinical presentation, history
of alcohol use/abuse with comorbid liver disease or renal
impairment, concurrent opioid use disorder, and other unique client
characteristics
◉Naltrexone (Revia, Vivitrol):. Answer: Initial treatment for alcohol
use disorder
-Start while still drinking
-Can treat concurrent opioid use disorder
-Contraindicated in liver disease
-May be given in monthly long-acting injections (Vivitrol)
◉Acamprosate (Campral). Answer: · Modulates glutamine
transmission, and resembles gamma-aminobutyric acid (GABA)
· Good option for clients who must take opioids for chronic pain
· Treats withdrawal symptoms
· Abstain prior to beginning treatment
No affect on Opioids
, ◉Disulfiram (Antabuse):. Answer: -Blocks oxidation of alcohol
-Creates unpleasant symptoms when the client drinks while taking
medication
-Palpitations
-Headache
-Nausea/vomiting
-Flushing
·-Abstain from alcohol for at least 12 hours prior to treatment to
avoid a reaction
-a disulfiram reaction can occur for up to 14 days after alcohol is
consumed
◉Topiramate (Topamax). Answer: · An anticonvulsant that blocks
sodium channels and enhances GABA-A
· Reduces cravings for alcohol
◉Chlorpromazine (Librium). Answer: · Benzodiazepine for acute
and chronic alcohol use
· Can cause benzodiazepine (BZO) withdrawal symptoms when
stopped abruptly
· Avoid in older adults
546 EXAM SCRIPT FINAL PAPER 2026
SOLVED QUESTION SET GRADED A+
◉SCENARIO: Nori is a 24-year-old who has a history of abusing
opioid medications and binge drinking. She is not committed to
abstain from using at this time.. Answer: MAT: naloxone
RATIONALE: Since Nori is not committed to abstaining at this time,
it is important to provide naloxone along with education to help her
remain safe from overdose.
◉SCENARIO: 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.. Answer:
MAT: naltrexone
RATIONALE:Naltrexone is a good option for clients who use opioids
and alcohol and are committed to abstinence
◉Pregnancy with Buprenorphine. Answer: Buprenorphine is an
acceptable treatment during pregnancy; however, there is an
increased risk of a neonatal withdrawal syndrome in newborns.
,◉Pregnancy with Suboxone (buprenorphine/naloxone). Answer:
Suboxone (buprenorphine/naloxone) cannot be used in pregnancy
◉Pregnancy with Naloxone. Answer: Naloxone increases the risk of
neonatal abstinence syndrome. Pregnant clients must be switched to
buprenorphine (Subutex) monotherapy.
◉Pregnancy with Methadone. Answer: Methadone is approved in
pregnancy for heroin-addicted women. Dosing requires adjustment.
◉Pregnancy in MAT. Answer: Short-term newborn withdrawal
effects may be seen and may require neonatal intensive care unit
(NICU) admission for treatment.
◉Breast Feeding with Naltrexone and Buprenorphine. Answer: Not
recommended
◉Breast Feeding with Methadone. Answer: Can be prescribed with
special consideration given to feeding intervals (breastfeed prior to
or 2-6 hours after dose).
◉Older Adult with Buprenorphine. Answer: Use in the elderly may
lead to confusion and drowsiness
,◉Older Adult with Methadone. Answer: Methadone has a high
potential for drug interactions, associated with QT prolongation.
It is difficult to titrate in the elderly and has a risk for accumulation
due to the long half-life
◉MAT for Chronic Alcohol Use Disorder. Answer: Medication
selections for MAT should be based on clinical presentation, history
of alcohol use/abuse with comorbid liver disease or renal
impairment, concurrent opioid use disorder, and other unique client
characteristics
◉Naltrexone (Revia, Vivitrol):. Answer: Initial treatment for alcohol
use disorder
-Start while still drinking
-Can treat concurrent opioid use disorder
-Contraindicated in liver disease
-May be given in monthly long-acting injections (Vivitrol)
◉Acamprosate (Campral). Answer: · Modulates glutamine
transmission, and resembles gamma-aminobutyric acid (GABA)
· Good option for clients who must take opioids for chronic pain
· Treats withdrawal symptoms
· Abstain prior to beginning treatment
No affect on Opioids
, ◉Disulfiram (Antabuse):. Answer: -Blocks oxidation of alcohol
-Creates unpleasant symptoms when the client drinks while taking
medication
-Palpitations
-Headache
-Nausea/vomiting
-Flushing
·-Abstain from alcohol for at least 12 hours prior to treatment to
avoid a reaction
-a disulfiram reaction can occur for up to 14 days after alcohol is
consumed
◉Topiramate (Topamax). Answer: · An anticonvulsant that blocks
sodium channels and enhances GABA-A
· Reduces cravings for alcohol
◉Chlorpromazine (Librium). Answer: · Benzodiazepine for acute
and chronic alcohol use
· Can cause benzodiazepine (BZO) withdrawal symptoms when
stopped abruptly
· Avoid in older adults
