Opioids: nalbuphine: 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 · Opioids: nalbuphine

Sample item

Nalbuphine acts on opioid receptors in which way?

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

The answer and the reasoning

B. Kappa agonist and mu antagonist or partial agonist, with a ceiling on respiratory depression

Nalbuphine is an agonist-antagonist opioid that activates kappa receptors and blocks or partially activates mu receptors. Respiratory depression and analgesia have a ceiling effect, which gives some safety, but it can precipitate withdrawal in opioid-dependent patients. It can also antagonise mu-mediated side effects such as pruritus.

Option by option

  • A. Pure delta agonist

    It is not a delta agonist.

  • B. Kappa agonist and mu antagonist or partial agonist, with a ceiling on respiratory depression (correct)

    Correct. This mixed action gives a ceiling effect.

  • C. Pure mu antagonist

    Naloxone is a pure mu antagonist.

  • D. Pure mu agonist

    Morphine is a pure mu agonist.

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 Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, Kappa agonist and mu antagonist or partial agonist, with a ceiling on respiratory depression. Nalbuphine is an agonist-antagonist opioid that activates kappa receptors and blocks or partially activates mu receptors.

Why is "Pure delta agonist" not the answer?

It is not a delta agonist.

Why is "Pure mu antagonist" not the answer?

Naloxone is a pure mu antagonist.

Why is "Pure mu agonist" not the answer?

Morphine is a pure mu agonist.

What concept does this question test?

It tests Opioids: nalbuphine in Anaesthesia. Respiratory depression and analgesia have a ceiling effect, which gives some safety, but it can precipitate withdrawal in opioid-dependent patients. It can also antagonise mu-mediated side effects such as pruritus.

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 Opioids: nalbuphine?

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.