Opioids: buprenorphine: 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: buprenorphine

Sample item

Which statement about buprenorphine is correct?

AIt is fully reversed by low dose naloxoneBIt is a pure mu antagonistCIt has no respiratory depression at any doseDIt is a partial mu agonist with a ceiling effect and is only partially reversed by naloxone

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

The answer and the reasoning

D. It is a partial mu agonist with a ceiling effect and is only partially reversed by naloxone

Buprenorphine binds mu receptors with high affinity and dissociates slowly, so it shows a ceiling effect and high-dose naloxone is required for reversal. It can displace other opioids and cause withdrawal.

Option by option

A. It is fully reversed by low dose naloxone
Reversal needs large doses of naloxone.
B. It is a pure mu antagonist
It is a partial agonist, not an antagonist.
C. It has no respiratory depression at any dose
Respiratory depression can occur.
D. It is a partial mu agonist with a ceiling effect and is only partially reversed by naloxone (correct)
Correct. It is a high-affinity partial 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.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, It is a partial mu agonist with a ceiling effect and is only partially reversed by naloxone. Buprenorphine binds mu receptors with high affinity and dissociates slowly, so it shows a ceiling effect and high-dose naloxone is required for reversal.

Why is "It is fully reversed by low dose naloxone" not the answer?

Reversal needs large doses of naloxone.

Why is "It is a pure mu antagonist" not the answer?

It is a partial agonist, not an antagonist.

Why is "It has no respiratory depression at any dose" not the answer?

Respiratory depression can occur.

What concept does this question test?

It tests Opioids: buprenorphine in Anaesthesia. It can displace other opioids and cause withdrawal.

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: buprenorphine?

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.