Opioids: tramadol: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Opioids: tramadol

Sample item

A patient with epilepsy and on sertraline is prescribed tramadol for pain. What is the main concern?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Lowered seizure threshold and risk of serotonin syndrome

Tramadol is a weak mu agonist that also inhibits reuptake of serotonin and noradrenaline, so it can lower the seizure threshold and combine with SSRIs to cause serotonin syndrome. Naloxone only partly reverses its effects.

Option by option

  • A. Lowered seizure threshold and risk of serotonin syndrome (correct)

    Correct. Seizure and serotonergic risk apply here.

  • B. Severe constipation exceeding other opioids

    Constipation is less than with strong opioids.

  • C. Pronounced miosis only

    Miosis is not the principal concern.

  • D. Hepatotoxicity as in paracetamol

    Hepatotoxicity is not a typical feature.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Lowered seizure threshold and risk of serotonin syndrome. Tramadol is a weak mu agonist that also inhibits reuptake of serotonin and noradrenaline, so it can lower the seizure threshold and combine with SSRIs to cause serotonin syndrome.

Why is "Severe constipation exceeding other opioids" not the answer?

Constipation is less than with strong opioids.

Why is "Pronounced miosis only" not the answer?

Miosis is not the principal concern.

Why is "Hepatotoxicity as in paracetamol" not the answer?

Hepatotoxicity is not a typical feature.

What concept does this question test?

It tests Opioids: tramadol in Pharmacology. Naloxone only partly reverses its effects.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Opioids: tramadol?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.