Malignant hyperthermia treatment — FRCA Primary MCQ

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ModeratePharmacologyMalignant hyperthermia treatmentFRCA Primary

After sevoflurane and suxamethonium, a patient develops rising end-tidal CO2, rigidity and hyperthermia. Which drug is most appropriate?

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Correct answer: E — Dantrolene

Dantrolene treats malignant hyperthermia by reducing sarcoplasmic reticulum calcium release. Adenosine 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. Metoclopramide is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Neostigmine 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