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Rapid sequence neuromuscular blocker — FRCA Primary MCQ

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HardPharmacologyRapid sequence neuromuscular blockerFRCA Primary

A patient with a full stomach needs rapid neuromuscular blockade but suxamethonium is contraindicated due to burns. Which drug is most appropriate?

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

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Correct answer: E — Rocuronium

High-dose rocuronium can provide rapid onset neuromuscular blockade when suxamethonium is contraindicated. Morphine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Magnesium sulphate 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. Hydrocortisone 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