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Anaesthesia · Intravenous and inhalational agents: pentazocine in myocardial infarction
Sample itemWhich opioid analgesic is relatively undesirable in acute myocardial infarction because it raises heart rate, systemic pressure and pulmonary arterial pressure, and can cause psychotomimetic effects?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Pentazocine
Pentazocine is a kappa agonist with weak mu antagonist activity. It increases heart rate, blood pressure and pulmonary artery pressure, and causes dysphoria and hallucinations, so it is avoided in myocardial infarction.
Option by option
A. Fentanyl
Fentanyl is haemodynamically stable and does not raise pulmonary pressures.
B. Pentazocine (correct)
Correct. Its sympathomimetic effects and psychotomimetic effects are a recognised problem.
C. Remifentanil
Remifentanil does not cause these effects.
D. Morphine
Morphine lowers preload and anxiety and is the usual opioid in myocardial infarction.
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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