Psychopharmacology: opioid to avoid with MAOI: practice question

A Psychiatry 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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Psychiatry · Psychopharmacology: opioid to avoid with MAOI

Sample item

A patient on phenelzine needs postoperative analgesia. Which opioid is particularly dangerous because of a severe interaction with MAOIs?

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

The answer and the reasoning

B. Pethidine

Pethidine has serotonergic activity and combined with an MAOI can cause agitation, hyperthermia, rigidity and collapse. Morphine is considered a safer opioid in this setting, and non-opioid analgesics are not affected.

Option by option

  • A. Diclofenac

    Diclofenac is an NSAID without an MAOI interaction.

  • B. Pethidine (correct)

    Correct. Pethidine plus an MAOI can cause severe serotonergic toxicity.

  • C. Morphine

    Morphine lacks the serotonergic action and is a safer choice.

  • D. Paracetamol

    Paracetamol is not an opioid and has no serotonergic interaction.

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 Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Pethidine. Pethidine has serotonergic activity and combined with an MAOI can cause agitation, hyperthermia, rigidity and collapse.

Why is "Diclofenac" not the answer?

Diclofenac is an NSAID without an MAOI interaction.

Why is "Morphine" not the answer?

Morphine lacks the serotonergic action and is a safer choice.

Why is "Paracetamol" not the answer?

Paracetamol is not an opioid and has no serotonergic interaction.

What concept does this question test?

It tests Psychopharmacology: opioid to avoid with MAOI in Psychiatry. Morphine is considered a safer opioid in this setting, and non-opioid analgesics are not affected.

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 Psychopharmacology: opioid to avoid with MAOI?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.