A known case of acute intermittent porphyria presents with an acute abdomen requiring surgical exploration and severe pain. Which agent is the safest perioperative analgesic choice?
- A Pentazocine
- B Morphine ✓
- C Midazolam
- D Thiopentone
Correct answer: B. Morphine
Explanation
Opioids such as morphine and pethidine are considered safe in acute porphyria and provide effective visceral analgesia. Thiopentone, like barbiturates, is a potent inducer of cytochrome P450 and is classically contraindicated; midazolam and several benzodiazepines carry risk via hepatic metabolism and enzyme induction, and pentazocine has been reported unsafe. Choosing the safe option tests knowledge of the porphyrinogenic drug list, a frequently examined point.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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