A patient with coronary artery disease and stable angina requires rapid sequence intubation. The anesthesiologist wishes to avoid tachycardia and hypertension. Which neuromuscular blocking agent is most likely to cause tachycardia and should be avoided?
- A Rocuronium
- B Vecuronium
- C Pancuronium ✓
- D Cisatracurium
Correct answer: C. Pancuronium
Explanation
Pancuronium causes tachycardia and hypertension due to its vagolytic (antimuscarinic) action and inhibition of norepinephrine reuptake from sympathetic nerve endings. This makes it unsuitable in patients where tachycardia increases myocardial oxygen demand. Rocuronium, vecuronium, and cisatracurium have minimal cardiovascular effects and are preferred in cardiac patients.
Reference: Katzung Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.