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Ketamine sympathetic response — FRCA Primary MCQ

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HardPharmacologyKetamine sympathetic responseFRCA Primary

A shocked trauma patient with bronchospasm requires induction before laparotomy. Ketamine is selected, but the patient is chronically taking high-dose β-blockers and is exhausted. Which cardiovascular response is most likely?

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

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Correct answer: E — Myocardial depression may become evident

Ketamine usually increases heart rate and blood pressure through sympathetic stimulation, but direct myocardial depressant effects may be revealed when catecholamine reserves are depleted or β-blockade is present. Histamine release is not the main issue with ketamine. Profound vagal bradycardia is not the expected pharmacological pattern. The teaching point is that ketamine is not intrinsically cardiostimulant; the apparent stimulation depends on an intact sympathetic response.

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