Certified Neuroscience Registered Nurse (CNRN) Practice Exam

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Which substance is known to assist in preventing opioid tolerance?

Dextromethorphan
Oxycodone
Codeine
Tramadol

The correct answer is: Dextromethorphan

Dextromethorphan is recognized for its ability to assist in preventing opioid tolerance due to its action as an NMDA receptor antagonist. When patients are treated with opioids, regular use can lead to tolerance, requiring higher doses to achieve the same level of pain relief. Dextromethorphan's mechanism of action helps to counteract some of the adaptations that the brain undergoes in response to continuous opioid exposure. This means it can prolong the effectiveness of opioid analgesics, allowing for better management of pain over time without the need to escalate dosages. The other substances listed, like oxycodone and codeine, are traditional opioids and do not have properties to prevent tolerance effectively. While tramadol has a unique profile and can have some NMDA antagonist effects, it is not as well-established as dextromethorphan for this particular role in preventing opioid tolerance.