Spinal hypotension alpha agonist — FRCA Primary MCQ

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HardPharmacologySpinal hypotension alpha agonistFRCA Primary

After spinal anaesthesia, a healthy patient becomes hypotensive with vasodilatation. Which drug is most appropriate?

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Correct answer: E — Phenylephrine

Phenylephrine is a predominantly alpha-1 agonist vasopressor. Esmolol is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Sevoflurane is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Metoclopramide 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