Neonatal Nurse Practitioner Practice Exam

What is the drug of choice when treating opioid withdrawal in neonates?

1. Diazepam

2. Methadone

3. Phenobarbitol

4. Buprenorphine

The correct answer is: Methadone

Methadone is commonly recognized as the drug of choice for treating opioid withdrawal in neonates due to its long-acting properties that help in stabilizing the withdrawal symptoms. In the setting of neonatal abstinence syndrome (NAS), which occurs in infants exposed to opioids in utero, methadone provides a controlled tapering effect that can reduce the severity of withdrawal symptoms in affected infants. Its action helps to minimize the peak withdrawal symptoms and allows for a gradual adjustment in the infant’s physiology. Moreover, methadone has established dosing protocols and a significant body of evidence supporting its use in this population, making it a first-line treatment option. The goal is to create a balance where the infant can safely withdraw from the opioids without experiencing distressing symptoms. While the other medications listed may be utilized in specific cases or settings, they do not have the same level of support as methadone in this context. For instance, benzodiazepines like diazepam can be used for sedation but are not ideal for opioid withdrawal, and phenobarbital, while useful for managing seizures and also sometimes used in treating withdrawal, does not have the same targeted efficacy for opioid-related symptoms. Buprenorphine, although effective in adult populations, is