Beta-2 agonist hyperkalaemia — FRCA Primary MCQ

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ModeratePharmacologyBeta-2 agonist hyperkalaemiaFRCA Primary

Severe hyperkalaemia is treated before dialysis by giving nebulised therapy that shifts potassium into cells. Which drug is most appropriate?

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Correct answer: C — Salbutamol

Salbutamol stimulates beta-2 receptors and promotes intracellular potassium shift via Na-K ATPase activation. Adenosine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Ephedrine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Protamine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Pancuronium 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