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Spinal hypotension with bradycardia — FRCA Primary MCQ

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HardPharmacologySpinal hypotension with bradycardiaFRCA Primary

A patient develops hypotension and bradycardia after spinal anaesthesia; a mixed direct and indirect sympathomimetic is chosen. Which drug is most appropriate?

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

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Correct answer: D — Ephedrine

Ephedrine increases blood pressure and heart rate through mixed sympathomimetic effects. Metoclopramide is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Salbutamol is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Noradrenaline is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Four-factor prothrombin complex concentrate with vitamin K 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