Etomidate choice in shock — FRCA Primary MCQ

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EasyPharmacologyEtomidate choice in shockFRCA Primary

A haemodynamically unstable patient is induced with a drug causing minimal cardiovascular depression but later adrenal suppression is considered. Which drug is most likely?

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Correct answer: C — Etomidate

Etomidate is relatively cardiovascularly stable but can suppress adrenal steroid synthesis. Adenosine 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. Morphine 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. 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