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Kathleen T. Brady, MD, PhD
Welcome and Program Introduction (6:15)
Richard N. Rosenthal, MD
Neuroadaptive Responses to Alcohol and Implications for Pharmacotherapy (1:08:30)
Kathleen T. Brady, MD, PhD
Optimizing Outcomes With Pharmacotherapies for Alcohol Dependence (55:00)
Kathleen T. Brady, MD, PhD, and Richard N. Rosenthal, MD
Case Studies: Incorporating Pharmacotherapies for Alcohol Dependence Into Clinical Practice (31:30)


TEST INSTRUCTIONS
Please answer the 12 questions below, and then click the SUBMIT button. You must correctly answer at least 9 questions to pass; however, you may retake an incorrectly answered question as many times as you wish.

Feel free to refer to the course materials on the course navigation page both before and during this test. Please note that ALL the material on which the questions are based can be found in the slide presentations (without the audio). After clicking the Submit button, scroll down to review brief explications of the answers.

Once you have passed the test, you will be directed to your personal CME account to complete the course survey and to receive your electronic CME certificate (PDF file). We hope you find this online activity both educational and enjoyable, and thank you once again for participating.

  1. In the normal CNS (ie, without exposure to alcohol), a complex system of neurotransmitters successfully maintains homeostasis in the brain and body by modulating activation of excitatory vs inhibitory neuronal pathways.

    A. True
    B. False

  2. Chronic alcohol consumption induces the brain to correct the alcohol-induced neurochemical "tilt" toward inhibition. It does so by instituting an opposing reaction by changing the number or sensitivity of specific neuroreceptors. What is this process called?

    A. Sensitization
    B. Homeostasis
    C. Neuroadaptation
    D. Opsonization
    E. None of the above

  3. Which of the following elicits physiologic tolerance to, and dependence upon, alcohol?

    A. A decrease in neuronal excitatory activity and a decrease in inhibitory activity
    B. An increase in neuronal excitatory activity and an increase in inhibitory activity
    C. An increase in neuronal excitatory activity and a decrease in inhibitory activity
    D. A decrease in neuronal excitatory activity and an increase in inhibitory activity
    E. None of the above

  4. Which of the following statements is true regarding the effects of alcohol on the endogenous opioid system?

    A. Acute alcohol consumption decreases the release of endorphins and enkephalins in certain individuals.
    B. Chronic alcohol consumption may increase endogenous opioid activity through adaptive down-regulation of receptors.
    C. Chronic alcohol consumption may decrease endogenous opioid activity through adaptive down-regulation of receptors.
    D. Chronic alcohol consumption may decrease endogenous opioid activity through adaptive up-regulation of receptors.

  5. The combination of a blunted hypothalamic-pituitary-adrenal response and a sensitized CNS corticotropin-releasing factor (CRF) response may contribute to vulnerability to relapse in alcohol-dependent individuals.

    A. True
    B. False

  6. Acute alcohol administration potentiates inhibitory activity of GABA at GABAA receptors, resulting in which of the following?

    A. Sedation
    B. Lack of coordination
    C. Anesthesia
    D. All of the above
    E. None of the above

  7. Chronic intermittent exposures to alcohol result in an increase in NMDA receptor function, leading to which of the following?

    A. Sensitization, an increased intensity of withdrawal symptoms after repeated alcohol exposure, and withdrawal episodes
    B. Atrophy of the suprachiasmatic nucleus
    C. A reduction in the number of hypocretin neurons
    D. An increase in the number of hypocretin neurons
    E. None of the above

  8. Which of the following statements is false?

    A. Disulfiram is contraindicated in people with ischemic heart disease and in women who are pregnant.
    B. Results of clinical studies of selective serotonin reuptake inhibitors in alcohol-dependent patients have mostly been negative.
    C. Pharmacological treatment of alcohol dependence should always be accompanied by psychosocial support.
    D. In Project MATCH, improvements in drinking outcomes were achieved only by patients who received 12-step facilitation therapy.

  9. Disulfiram appears to reduce drinking and increase abstinence by affecting the dopaminergic pathways associated with positive reinforcement and reduced craving for alcohol.

    A. True
    B. False

  10. In alcohol-dependent individuals, acamprosate is hypothesized to reduce the pathological overactivation of the glutamate system.

    A. True
    B. False

  11. Which of the following is most commonly associated with the use of naltrexone?

    A. Nausea
    B. Weight gain
    C. Tinnitus
    D. None of the above

  12. In the clinical trials presented on the various pharmacotherapies for alcohol dependence, the patient requirements for study admittance were identical.

    A. True
    B. False