AIIMS Delhi NO- 2019
Pharmacology
Easy
In rehabilitation center, which of the following drug is used as opioid substitute in substance abuse patient?
Appeared in: AIIMS Delhi NO- 2019
Explanation
- Buprenorphine is a partial opioid agonist specifically indicated for Opioid Substitution Therapy (OST) in patients with opioid use disorder.
- It works by binding tightly to mu-opioid receptors, which reduces cravings and withdrawal symptoms without producing the intense euphoria of full agonists.
- A key feature is its 'ceiling effect,' which limits its potential for causing respiratory depression, making it a safer option compared to drugs like methadone.
- Its high affinity for opioid receptors allows it to block the effects of other opioids, such as heroin, if they are used.
Why Other Options Were Wrong
- Option B: Bupinone is not a recognized or approved medication in pharmacology. It serves as a distractor in this context.
- Option C: Haloperidol is a typical antipsychotic medication. Its primary use is for managing psychosis, not for treating opioid dependence.
- Option D: Quetiapine is an atypical antipsychotic. It is not an opioid substitute.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Pharmacological treatment for opioid use disorder to guide bedside assessment, documentation, and the next nursing action.
- Nurses play a crucial role in Opioid Substitution Therapy (OST) by administering medication, monitoring for withdrawal symptoms using scales like COWS, and providing patient education on safety and adherence.
- A key safety aspect is initiating buprenorphine only when a patient is in mild to moderate withdrawal. Administering it too early can precipitate severe withdrawal symptoms.
- What if? If the patient had a co-occurring diagnosis of acute psychosis, Haloperidol or Quetiapine might be used to manage psychotic symptoms, but they would not replace the need for an opioid substitute like buprenorphine.
How to Approach the Question
- First, identify the core of the question, which is asking for a specific medication used as an 'opioid substitute' in a 'rehabilitation' setting.
- Scan the options. The names are pharmacological. The task is to match the drug to the specific indication (opioid substitution).
- Recall or deduce the drug classes. Buprenorphine is related to opioids. Haloperidol and Quetiapine are known antipsychotics.
- Eliminate the antipsychotics (Haloperidol, Quetiapine) as they are used for mental health disorders, not directly for opioid substitution.
- Evaluate the remaining options. Buprenorphine is a well-established medication for this purpose. 'Bupinone' is an unfamiliar name, making it a likely distractor.
- Conclude that Buprenorphine is the correct medication used in Opioid Substitution Therapy.
Concept Tested & Keywords
- Concept Tested: Pharmacological treatment for opioid use disorder.
- Stem keywords: rehabilitation center, opioid substitute, substance abuse
- Lead-in keywords: which of the following
- Negative lead-in flag: false
Question ID
QPW_IF8I-wdVrUW5SgB5cC
Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 951-953
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4599-4601
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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