Drug of choice for withdrawal syndrome in a neonate due to maternal opiate addiction is-
**Core Concept**
The question is testing the ability to manage neonatal abstinence syndrome (NAS), a condition caused by exposure to maternal opioids during pregnancy. The underlying pharmacological principle is the use of opioid receptor antagonists to reverse or alleviate withdrawal symptoms.
**Why the Correct Answer is Right**
The drug of choice for NAS is **naloxone**, an opioid receptor antagonist that rapidly reverses opioid effects. Naloxone works by competitively binding to opioid receptors, thereby blocking the action of endogenous opioids and reducing withdrawal symptoms. The use of naloxone is preferred over other opioid receptor antagonists due to its rapid onset and short duration of action.
**Why Each Wrong Option is Incorrect**
**Option A:** Methadone is an opioid agonist commonly used for opioid substitution therapy in pregnant women, but it is not the first-line treatment for NAS.
**Option B:** Buprenorphine is a partial opioid agonist used for opioid substitution therapy, but it can actually worsen NAS symptoms due to its partial agonist activity.
**Option C:** Clonidine is an alpha-2 adrenergic agonist used as a adjunct therapy to manage NAS symptoms, but it is not the primary treatment.
**Clinical Pearl / High-Yield Fact**
Remember that NAS is a diagnosis of exclusion, and treatment should only be initiated after ruling out other causes of neonatal distress, such as infection or congenital anomalies.
**Correct Answer: A. Naloxone**