Review of Pharmacology - 9E (2015)

Anaesthesia
• The patient underwent rapid sequence intubation (RSI). A depolarizing neuromuscular blocking drug is commonly
administered for RSI, because onset of action is generally more rapid (within 60 seconds) than for most available nondepolarizing
blockers.
• The patient still exhibits residual muscle paralysis even after neostigmine, an anti-cholinesterase. The persistence of
paralysis indicates that Drug A is a depolarizing blocker. Anticholinesterases do not reverse the action of depolarizing
and may, in fact, enhance them.
The only depolarizing blocker listed among the options is succinylcholine. In patients with atypical pseudocholinesterase,
SCh may produce prolonged paralysis and apnea.
71. Ans. (d) Suxamethonium (Ref: Katzung 11/e p454)
Suxamethonium is the other name of succinylcholine. It is the shortest acting muscle relaxant due to metabolism by pseudocholinesterase
72. Ans. (a) Atracurium (Ref: KDT 6/e p345)
73. Ans. (d) Quinidine (Ref: Clinical Anesthesiology by Murray and Morgan/189;KDT 6/e p346)
Non-depolarizing blockade is potentiated by
Hypothermia
Hypokalemia
Hypermagnesemia
Aminoglycosides, Tetracyclines, Polymyxin B
Trimethaphan
MgSO 4
Ketamine
74. Ans. (a) Chloramphenicol (Ref: KDT 6/e p346)
Drugs causing curare like effect are:
• Aminoglycosides
• Polypeptide antibiotics:
––
Polymyxin B
––
Bacitracin
––
Colistin
––
Tyrothricin
• Tetracycline
• Clindamycin, lincomycin
Respiratory acidosis
Hypocalcemia
Neonatal period
Quinine, Lignocaine, CCBs, Procainamide
Dantrolene
Local Anaesthetics
General Anaesthesia Pharmacology
75. Ans. (b) Vecuronium (Ref: KDT 5/e p345)
It does not cause ganglion blockade or histamine release and is having good cardiovascular stability.
76. Ans. (b) Depolarising muscle relaxant (Ref: KDT 6/e p339 )
77. Ans. (a) Centrally acting muscle relaxant (Ref: Katzung 11/e p463)
78. Ans. (d) All of the above (Ref: Katzung 11/e p457)
79. Ans. (c) Succinylcholine (Ref: KDT 6/e p343)
80. Ans. (c) Pancuronium (Ref: KDT 6/e p343)
81. Ans. (d) Amitryptiline (Ref: Katzung 11/e p462-464)
82. Ans. (a) Atracurium (Ref: KDT 6/e p345)
83. Ans. (b) Mivacurium (Ref: KDT 6/e p339)
84. Ans. (c) Progression to dual blockade (Ref: Katzung 11/e p457)
85. Ans. (d) All of the above (Ref: KDT 6/e p348)
86. Ans. (c) Ketamine (Ref: Goodman and Gilman 12/e p538-539)
Ketamine increases all pressures (blood pressure, intracranial tension, intraocular pressure) in the body. It is therefore
intravenous anaesthetic of choice for shock (increases blood pressure).
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