Dexamethasone hyperglycaemia — FRCA Primary MCQ

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EasyPharmacologyDexamethasone hyperglycaemiaFRCA Primary

A patient with poorly controlled type 2 diabetes receives antiemetic prophylaxis during a laparoscopic cholecystectomy. Post-operative glucose is higher than expected. Which antiemetic is most likely to contribute?

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Correct answer: B — Dexamethasone

Dexamethasone is effective for postoperative nausea and vomiting but can increase blood glucose, particularly in patients with diabetes. Ondansetron is more associated with QT prolongation and constipation than hyperglycaemia. Droperidol may prolong QT, while cyclizine is sedating and anticholinergic. Antiemetic plans should account for metabolic risk as well as nausea risk.

Reference: BNF; Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care