© 2025 ALL RIGHTS RESERVED.
NURS 660-EXAM 4 EXAM QUESTIONS
CORRECT ANSWERS NEW UPDATE
(VERIFIED A+ PASS)
Methadone is a _____ mu opioid receptor agonist. Side effects include _____ and _____ -
Answer✔Full. Constipation, sedation.
Buprenorphine (suboxone) is a _____ at the opioid receptor. Often combined with naltrexone to
prevent abuse - Answer✔Partial agonist
Naloxone (Narcan) is a mu receptor _____ . it has little effect compared to buprenorphine
(usually 1:4 ratio). - Answer✔Antagonist
When buprenorphine/naloxone is injected or inhaled the ANTAGONIST effects of _____
dominate and w/d symptoms are precipitated - Answer✔Naloxone
Overdose is much more likely with ____ than _____ - Answer✔Methadone (full agonist) >
buprenorphine (partial agonist)
Extended-release buprenorphine can be dosed ____ - Answer✔Subcutaneous once per month
after demonstrating tolerability for 1-week oral dosing
Naltrexone (ReVia) is a Mu receptor antagonist. Consideration before starting _____ -
Answer✔Opiate free 7-10d or w/d symptoms
Naltrexone (ReVia) is available as once-monthly injection. How does it work? ____ -
Answer✔Blocks Mu receptors to prevent euphoric effects if patient relapses. Helps with
abstinence to eliminate reward
3 meds FDA approved for AUD - Answer✔Disufiram, Acamprosate, Naltrexone. Off-label =
Gabapentin and topiramate
NIAAA defines 'At risk' for men _____. Women _____. Above age 65 _____ - Answer✔Men=
4/day, 14/week. Women= 3/day, 7/week. >65= same as for women
Binge drinking for men _____, for women=_____ - Answer✔Men= 5 in 2 hrs. Women= 4 in 2
hrs
Describe transmitters involved in etOH withdrawal - Answer✔Over time alcoholics up-regulate
Glutamate to match the excess GABA. When there's a withdrawal there is a relative excess
1
, © 2025 ALL RIGHTS RESERVED.
Timeline of alcohol withdrawal - Answer✔Minor- within 36 hrs. Seizures- 1-2d. Hallucinosis- 1-
2d. DT's- 1-4d
Disulfiram (Antabuse) adverse effects - Answer✔Metallic taste, hepatotoxicity, optic neuritis,
peripheral neuropathy. (causes physically ill from buildup of acetaldehyde)
Acamprosate (Camral), how does it work? - Answer✔Dosed 3x's/day. Cleared renally.
Glutamate receptor modulator.
How does naltrexone (ReVia) work in alcohol cessation. - Answer✔Blocks opioid Mu receptors
and secondary dopamine (reduce pleasure and cravings)
Naltrexone extended release (Vivitrol) adverse effects - Answer✔Nausea, vomiting, precipitated
opioid withdrawal, depression, elevated LFT's
Mild withdrawal starts within ____ hours and resolve in _____. These include: - Answer✔6-24.
resolve 1-2 days. Tremor, anxiety, headache, insomnia, GI upset
Hallucinations start within _____ and resolve in _____ - Answer✔12-24 hrs, resolve 1-2days
Moderate and Severe withdrawal starts within _____ and lasts _____ - Answer✔1-3 days, can
last 5-7
DT's start _____ and can last _____ - Answer✔3-4 days and last 2-3 days
Triad of Wernicke's - Answer✔Encephalopathy, oculomotor dysfunction, gait ataxia (often
progresses to Korsakoff syndrome)
Wernicke-Korsakoff psychosis - Answer✔COAT (Wernickes) RACK (Korsakoffs). Confusion,
ophthalmoplegia, Ataxia, Thiamine def. RACK= Retrograde and Anterograde amnesia,
Confabulation, Korsakoff psychosis
Opioid use disorder and neurotransmitter - Answer✔Lowers NE and the brain up-regulates to
make more. When the opioid is removed there is a relative excess surge of NE
Drug classes that help treat opioid w/d - Answer✔Alpha 2 agonists (Clonidine, Methyldopa,
Tizanidine, Guanfacine), Beta blockers, SNRI
Impulsivity and reward= _____ striatum. Compulsivity and motor response inhibition= _____
striatum - Answer✔Ventral, dorsal
Reward pathway: mesolimbic from the _____ to the _____ - Answer✔VTA to the Nucleus
accumbens (specifically in regards to dopamine)
Drugs of abuse cause DA release in the _____ - Answer✔Mesolimbic pathway
Pathology of Alzheimer's - Answer✔Amyloid/ Tau
Pathology of Parkinson's / dementia w/ Lewy bodies - Answer✔Alpha-synuclein
Pathology of Huntington's - Answer✔Trinucleotide repeat
2
NURS 660-EXAM 4 EXAM QUESTIONS
CORRECT ANSWERS NEW UPDATE
(VERIFIED A+ PASS)
Methadone is a _____ mu opioid receptor agonist. Side effects include _____ and _____ -
Answer✔Full. Constipation, sedation.
Buprenorphine (suboxone) is a _____ at the opioid receptor. Often combined with naltrexone to
prevent abuse - Answer✔Partial agonist
Naloxone (Narcan) is a mu receptor _____ . it has little effect compared to buprenorphine
(usually 1:4 ratio). - Answer✔Antagonist
When buprenorphine/naloxone is injected or inhaled the ANTAGONIST effects of _____
dominate and w/d symptoms are precipitated - Answer✔Naloxone
Overdose is much more likely with ____ than _____ - Answer✔Methadone (full agonist) >
buprenorphine (partial agonist)
Extended-release buprenorphine can be dosed ____ - Answer✔Subcutaneous once per month
after demonstrating tolerability for 1-week oral dosing
Naltrexone (ReVia) is a Mu receptor antagonist. Consideration before starting _____ -
Answer✔Opiate free 7-10d or w/d symptoms
Naltrexone (ReVia) is available as once-monthly injection. How does it work? ____ -
Answer✔Blocks Mu receptors to prevent euphoric effects if patient relapses. Helps with
abstinence to eliminate reward
3 meds FDA approved for AUD - Answer✔Disufiram, Acamprosate, Naltrexone. Off-label =
Gabapentin and topiramate
NIAAA defines 'At risk' for men _____. Women _____. Above age 65 _____ - Answer✔Men=
4/day, 14/week. Women= 3/day, 7/week. >65= same as for women
Binge drinking for men _____, for women=_____ - Answer✔Men= 5 in 2 hrs. Women= 4 in 2
hrs
Describe transmitters involved in etOH withdrawal - Answer✔Over time alcoholics up-regulate
Glutamate to match the excess GABA. When there's a withdrawal there is a relative excess
1
, © 2025 ALL RIGHTS RESERVED.
Timeline of alcohol withdrawal - Answer✔Minor- within 36 hrs. Seizures- 1-2d. Hallucinosis- 1-
2d. DT's- 1-4d
Disulfiram (Antabuse) adverse effects - Answer✔Metallic taste, hepatotoxicity, optic neuritis,
peripheral neuropathy. (causes physically ill from buildup of acetaldehyde)
Acamprosate (Camral), how does it work? - Answer✔Dosed 3x's/day. Cleared renally.
Glutamate receptor modulator.
How does naltrexone (ReVia) work in alcohol cessation. - Answer✔Blocks opioid Mu receptors
and secondary dopamine (reduce pleasure and cravings)
Naltrexone extended release (Vivitrol) adverse effects - Answer✔Nausea, vomiting, precipitated
opioid withdrawal, depression, elevated LFT's
Mild withdrawal starts within ____ hours and resolve in _____. These include: - Answer✔6-24.
resolve 1-2 days. Tremor, anxiety, headache, insomnia, GI upset
Hallucinations start within _____ and resolve in _____ - Answer✔12-24 hrs, resolve 1-2days
Moderate and Severe withdrawal starts within _____ and lasts _____ - Answer✔1-3 days, can
last 5-7
DT's start _____ and can last _____ - Answer✔3-4 days and last 2-3 days
Triad of Wernicke's - Answer✔Encephalopathy, oculomotor dysfunction, gait ataxia (often
progresses to Korsakoff syndrome)
Wernicke-Korsakoff psychosis - Answer✔COAT (Wernickes) RACK (Korsakoffs). Confusion,
ophthalmoplegia, Ataxia, Thiamine def. RACK= Retrograde and Anterograde amnesia,
Confabulation, Korsakoff psychosis
Opioid use disorder and neurotransmitter - Answer✔Lowers NE and the brain up-regulates to
make more. When the opioid is removed there is a relative excess surge of NE
Drug classes that help treat opioid w/d - Answer✔Alpha 2 agonists (Clonidine, Methyldopa,
Tizanidine, Guanfacine), Beta blockers, SNRI
Impulsivity and reward= _____ striatum. Compulsivity and motor response inhibition= _____
striatum - Answer✔Ventral, dorsal
Reward pathway: mesolimbic from the _____ to the _____ - Answer✔VTA to the Nucleus
accumbens (specifically in regards to dopamine)
Drugs of abuse cause DA release in the _____ - Answer✔Mesolimbic pathway
Pathology of Alzheimer's - Answer✔Amyloid/ Tau
Pathology of Parkinson's / dementia w/ Lewy bodies - Answer✔Alpha-synuclein
Pathology of Huntington's - Answer✔Trinucleotide repeat
2
