Cocaine Use Disorder

Course #56945-


Study Points

  1. Describe the history and background of cocaine use, including the development of different forms of the drug.
  2. Discuss the epidemiology of cocaine use.
  3. Describe the pharmacodynamics and pharmacokinetics of cocaine.
  4. Review the acute and chronic effects of cocaine use, including effects on fetal development.
  5. Select possible treatment modalities for cocaine use disorder, including psychosocial therapy, pharmacotherapy, immunotherapy options, alternative/complementary approaches, and interventions for non-English-proficient patients.
  6. Recognize the withdrawal syndrome associated with cessation of cocaine use.

    1 . The first wave of cocaine use in the United States began during the
    A) late 1600s.
    B) late 1800s.
    C) 1940s and 1950s.
    D) 1980s.

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    2 . During the industrial revolution, cocaine was highly valued for its ability to
    A) increase appetite.
    B) reduce the need for sleep.
    C) produce mind-altering effects.
    D) None of the above

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    3 . The resurgence of cocaine use in the late 1960s coincided with
    A) the first isolation and synthesis of cocaine.
    B) the marketing of crack, a new form of cocaine.
    C) decreased availability of heroin in the United States.
    D) tighter regulatory control and decreased use of amphetamines.

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    4 . Freebase is a form of cocaine manufactured by
    A) combining cocaine with heroin.
    B) treating cocaine with hydrochloric acid.
    C) removing the hydrochloride base of processed cocaine.
    D) dissolving cocaine hydrochloride in water, adding baking soda, then heating.

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    5 . In 2021, how many individuals 12 years of age or older were classified as dependent on or abusing cocaine?
    A) 500,000
    B) 1.4 million
    C) 5 million
    D) 25 million

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    6 . Populations at higher risk for cocaine-induced toxicity include all of the following, EXCEPT:
    A) Infants
    B) Adolescents
    C) Pregnant women
    D) Patients with liver disease

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    7 . Male cocaine abusers are more likely than women to
    A) have antisocial personality disorder.
    B) experience cardiovascular effects of the drug.
    C) be severely dependent or to abuse other drugs.
    D) be diagnosed with paranoid personality disorder.

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    8 . Action involving which neurotransmitter is the most important in producing the reinforcing effects of cocaine?
    A) Choline
    B) Serotonin
    C) Dopamine
    D) Norepinephrine

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    9 . The basis of cocaine's mechanism of action is
    A) stimulating the release of dopamine.
    B) decreased transmission of serotonin and norepinephrine.
    C) increased postsynaptic dopamine activity following its blocked presynaptic reuptake.
    D) None of the above

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    10 . The effects of cocaine are felt most rapidly and intensely when administered
    A) by smoking.
    B) intranasally.
    C) cutaneously.
    D) intravenously.

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    11 . Peak plasma levels of cocaine occur how long after intranasal ingestion?
    A) 2 to 4 minutes
    B) 20 to 40 minutes
    C) 2 to 4 hours
    D) 12 to 14 hours

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    12 . Physiologic signs of acute cocaine ingestion include
    A) decreased arterial pressure.
    B) increased locomotor activity.
    C) decreased myocardial oxygen demand.
    D) hypothermia secondary to vasodilatation.

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    13 . Cerebrovascular complications of chronic cocaine use are the result of its effects on noradrenergic neurotransmission and include
    A) vasodilatation.
    B) increase in blood flow.
    C) inflammation of blood vessel walls.
    D) All of the above

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    14 . Cardiac complications of cocaine use
    A) are only the result of chronic administration of the drug.
    B) are rare, as the drug has little affinity for cardiac tissue.
    C) are induced only in those individuals with a positive history for cardiac conditions.
    D) stem primarily from the powerful sympathomimetic properties of the drug.

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    15 . The most common gastrointestinal complication of chronic cocaine use is
    A) liver toxicity.
    B) malnutrition.
    C) acute bowel perforation.
    D) gastroduodenal ulceration.

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    16 . In the treatment of cocaine use disorder, community reinforcement approaches
    A) are relatively low cost and require little labor or commitment.
    B) provide competing reinforcement through the development of a positive lifestyle.
    C) aim to increase abstinence by forcing the individual to become isolated in an effort to remove environmental cues.
    D) None of the above

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    17 . When used for patients with cocaine use disorder, motivational-enhancement therapy
    A) seems to be more effective in those with low initial levels of motivation.
    B) tends to result in fewer total days of cocaine use, but a greater risk for relapse.
    C) strives to build and strengthen relationships and establish appropriate leisure activities.
    D) helps patients build internal motivation through the resolution of issues related to past trauma.

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    18 . It has been hypothesized that disulfiram may be a helpful drug for the treatment of cocaine use disorder based on what action?
    A) Decrease in available dopamine
    B) Inhibition of aldehyde dehydrogenase
    C) Increase in the metabolite acetaldehyde
    D) Inhibition of the enzyme that converts dopamine to norepinephrine

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    19 . Vaccine therapy for cocaine use disorder has been considered in part due to
    A) its ability to eliminate cravings.
    B) disappointing results of pharmacotherapy trials that targeted reward pathways.
    C) its protection against stimulant drugs that are structurally distinct from cocaine.
    D) the lack of variation in antibody formation across cocaine-dependent individuals.

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    20 . A triphasic abstinence syndrome from heavy cocaine use has been identified. Phase two is characterized by
    A) a peak in feelings of paranoia.
    B) episodic craving that is gradually extinguished.
    C) prolonged anhedonia, impaired motivation, and an increased risk for relapse.
    D) acute withdrawal symptoms, including depression, tachycardia and unstable blood pressure.

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