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Pancuronium tachycardia — FRCA Primary MCQ

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EasyPharmacologyPancuronium tachycardiaFRCA Primary

After an older aminosteroid neuromuscular blocker, a patient develops tachycardia during an otherwise stable anaesthetic. Which drug is most likely?

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

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Correct answer: C — Pancuronium

Pancuronium can cause tachycardia through vagolytic and sympathomimetic effects. Suxamethonium is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Dantrolene 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. Amiodarone 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