Pain: methadone: 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 · Pain: methadone

Sample item

Which adverse effect of methadone requires ECG monitoring in patients on long-term therapy?

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

The answer and the reasoning

B. QT interval prolongation

Methadone is a long-acting mu agonist with NMDA antagonist activity and a half-life of 24 hours or more, so it accumulates. It prolongs the QT interval and can cause torsades de pointes, particularly at high doses or with other QT-prolonging drugs. ECG monitoring is advised for patients on high doses.

Option by option

  • A. Shortened PR interval

    A shortened PR interval is not a feature of methadone.

  • B. QT interval prolongation (correct)

    Correct. QT prolongation and torsades de pointes are the key cardiac risks.

  • C. ST elevation

    ST elevation is not a recognised effect.

  • D. Bundle branch conduction block only

    The recognised risk is QT prolongation and not isolated bundle branch block.

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.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, QT interval prolongation. Methadone is a long-acting mu agonist with NMDA antagonist activity and a half-life of 24 hours or more, so it accumulates.

Why is "Shortened PR interval" not the answer?

A shortened PR interval is not a feature of methadone.

Why is "ST elevation" not the answer?

ST elevation is not a recognised effect.

Why is "Bundle branch conduction block only" not the answer?

The recognised risk is QT prolongation and not isolated bundle branch block.

What concept does this question test?

It tests Pain: methadone in Anaesthesia. It prolongs the QT interval and can cause torsades de pointes, particularly at high doses or with other QT-prolonging drugs. ECG monitoring is advised for patients on high doses.

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 Pain: methadone?

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.