Match each pharmacologic agent used in the treatment of substance use disorders with its corresponding mechanism of action, clinical profile, or key contraindication.
- NaltrexoneMu-opioid receptor antagonist that decreases alcohol cravings; contraindicated in acute hepatitis or liver failure.
- AcamprosateGlutamate modulator used to maintain abstinence in alcohol use disorder; contraindicated in patients with severe renal impairment.
- BuprenorphinePartial mu-opioid agonist with a ceiling effect on respiratory depression; can precipitate withdrawal if initiated prematurely.
- MethadoneFull mu-opioid agonist with a long half-life; associated with a risk of QTc interval prolongation.
- DisulfiramAldehyde dehydrogenase inhibitor used as an aversive therapy; requires strict abstinence and high patient motivation.
Cevap
Naltrexone matches with the mu-opioid receptor antagonist contraindicated in liver disease. Acamprosate matches with the glutamate modulator contraindicated in severe renal impairment. Buprenorphine matches with the partial agonist that can precipitate withdrawal. Methadone matches with the full agonist associated with QTc prolongation. Disulfiram matches with the aldehyde dehydrogenase inhibitor.
Each medication has distinct pharmacological properties and contraindications. Naltrexone reduces alcohol and opioid cravings but can cause hepatotoxicity. Acamprosate helps maintain alcohol abstinence but is renally cleared. Buprenorphine's partial agonism provides safety against overdose but risks precipitated withdrawal. Methadone is a full agonist requiring QTc monitoring. Disulfiram is an aversive agent that inhibits aldehyde dehydrogenase.
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Anahtar Kavram
Pharmacotherapy for substance use disorders requires careful selection based on receptor pharmacology (full vs. partial agonists) and medical comorbidities (hepatic vs. renal impairment).
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