Pain: transdermal fentanyl: practice question

A Anaesthesia 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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Anaesthesia · Pain: transdermal fentanyl

Sample item

Why is a transdermal fentanyl patch unsuitable for treating acute postoperative pain in an opioid-naive patient?

AIt is absorbed only through the gutBIt has no analgesic effectCSlow onset and long offset make titration impossible and risk respiratory depressionDIt acts too rapidly to titrate

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

The answer and the reasoning

C. Slow onset and long offset make titration impossible and risk respiratory depression

A fentanyl patch takes 12 to 24 hours to reach effect and levels continue for many hours after removal because of the skin depot. This prevents rapid titration and is dangerous in opioid-naive patients. Patches are for stable chronic pain in opioid-tolerant patients, and fever or heat increase absorption.

Option by option

A. It is absorbed only through the gut
The patch delivers drug through the skin, not the gut.
B. It has no analgesic effect
Fentanyl is a potent analgesic when absorbed.
C. Slow onset and long offset make titration impossible and risk respiratory depression (correct)
Correct. Slow onset and prolonged offset make acute titration unsafe.
D. It acts too rapidly to titrate
Onset is slow, not rapid.

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.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is C, Slow onset and long offset make titration impossible and risk respiratory depression. A fentanyl patch takes 12 to 24 hours to reach effect and levels continue for many hours after removal because of the skin depot.

Why is "It is absorbed only through the gut" not the answer?

The patch delivers drug through the skin, not the gut.

Why is "It has no analgesic effect" not the answer?

Fentanyl is a potent analgesic when absorbed.

Why is "It acts too rapidly to titrate" not the answer?

Onset is slow, not rapid.

What concept does this question test?

It tests Pain: transdermal fentanyl in Anaesthesia. This prevents rapid titration and is dangerous in opioid-naive patients. Patches are for stable chronic pain in opioid-tolerant patients, and fever or heat increase absorption.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Pain: transdermal fentanyl?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia 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.