The section, EDAIC MCQs with explanations, covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.
Question: In a patient known to have reactive asthmatic tendency, drugs that should be avoided in the perioperative settings:
- Atracurium
- Esmolol
- Inhalational anaesthetics
- d-tubocurarine
- Mivacurium
Answers:
- true
- true
- false
- true
- true
Explanation:
Drug triggers for bronchospasm in a susceptible patient during the perioperative period (histamine release, muscarinic activity, or by provoking allergic reactions):
- d tubocurarine
- Non-synthetic opioids: morphine **
- Atracurium **
- Mivacurium
- Rapacuronium was removed from the market because of its muscarinic receptor-mediated bronchospastic effects
- Beta-blockers *
- Ester LAs
- Protamine
- Drug preservatives
- Metabisulphite in propofol
- Antibiotics
- Vancomycin
*Esmolol has a very short duration of action and relative lack of effect on airway resistance, is unlikely to precipitate bronchospasm under ordinary circumstances. In usual therapeutic doses, it causes little or no bronchospasm in patients with asthma. However, there is a potential risk of spasm in patients with highly reactive airways and high doses of esmolol.
**In well-controlled asthmatics, morphine and atracurium in routine doses are low risk
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‘EDAIC MCQs with explanations’ covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.
