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Porphyria Safe Drugs — FRCA Final MCQ

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ModerateGeneral AnaesthesiaPorphyria Safe DrugsFRCA Final

A 50-year-old woman (ASA III) with known porphyria (acute intermittent porphyria) requires emergency cholecystectomy. Which anaesthetic drug is SAFE to use?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Propofol

Propofol is considered safe in porphyria. Unsafe drugs include: thiopental (most commonly cited contraindicated drug), etomidate, barbiturates, some benzodiazepines (midazolam is controversial – diazepam is safer), diclofenac, ketorolac, and ergot alkaloids. Safe drugs include: propofol, opioids (fentanyl, morphine, remifentanil), suxamethonium, non-depolarising muscle relaxants (atracurium, rocuronium), volatile agents (sevoflurane, isoflurane, desflurane), N2O, paracetamol, and local anaesthetics. The British Porphyria website maintains an up-to-date drug safety database.

Reference: British Porphyria Network – 2023 – Drug safety database; RCOA – 2023 – Final FRCA curriculum: porphyria