Pharmacology: remimazolam: 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 · Pharmacology: remimazolam

Sample item

What is a distinguishing feature of remimazolam?

AAn alpha-2 agonist metabolised by the kidneyBAn opioid with context-insensitive half-timeCA barbiturate with long durationDAn ultra-short-acting benzodiazepine metabolised by tissue esterases and reversible with flumazenil

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

The answer and the reasoning

D. An ultra-short-acting benzodiazepine metabolised by tissue esterases and reversible with flumazenil

Remimazolam is a benzodiazepine designed with an ester linkage, so tissue esterases rapidly convert it to an inactive metabolite. This gives fast onset and offset, making it suitable for procedural sedation and general anaesthesia. Its effects are reversed by flumazenil.

Option by option

A. An alpha-2 agonist metabolised by the kidney
Dexmedetomidine is an alpha-2 agonist.
B. An opioid with context-insensitive half-time
Remifentanil is the opioid with context-insensitive characteristics.
C. A barbiturate with long duration
It is a benzodiazepine, not a barbiturate.
D. An ultra-short-acting benzodiazepine metabolised by tissue esterases and reversible with flumazenil (correct)
Correct. Ester metabolism gives it ultra-short action while flumazenil can still reverse it.

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 D, An ultra-short-acting benzodiazepine metabolised by tissue esterases and reversible with flumazenil. Remimazolam is a benzodiazepine designed with an ester linkage, so tissue esterases rapidly convert it to an inactive metabolite.

Why is "An alpha-2 agonist metabolised by the kidney" not the answer?

Dexmedetomidine is an alpha-2 agonist.

Why is "An opioid with context-insensitive half-time" not the answer?

Remifentanil is the opioid with context-insensitive characteristics.

Why is "A barbiturate with long duration" not the answer?

It is a benzodiazepine, not a barbiturate.

What concept does this question test?

It tests Pharmacology: remimazolam in Anaesthesia. This gives fast onset and offset, making it suitable for procedural sedation and general anaesthesia. Its effects are reversed by flumazenil.

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 Pharmacology: remimazolam?

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.