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Desflurane airway irritation — FRCA Primary MCQ

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ModeratePharmacologyDesflurane airway irritationFRCA Primary

Rapidly increasing a volatile agent during induction causes coughing, breath-holding and tachycardia. Which drug is most likely?

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

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Correct answer: A — Desflurane

Desflurane is pungent and can cause airway irritation and sympathetic stimulation. Rocuronium is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Dexamethasone is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Bupivacaine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Ondansetron is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.

Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks