Paper I — 2020 February (Supplementary) (2010 Scheme) — Q2
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Paper I
2020 February (Supplementary) (2010 Scheme) · 40 marks · 120 min
Question
A middle aged man posted for Appendisectomy was given an injection by the ward
nurse before being shifted to the operation theatre. Patient developed dryness of
mouth, difficulty in swallowing and severe thirst.
What is the drug that was injected
Why the drug was given pre-operatively
What are the other drugs which are given pre-operatively (1+2+3)
Q26 marksEssays
Answer
(a) Drug injected
Atropine (or Glycopyrrolate) — an anticholinergic, given as preanaesthetic medication; the symptoms described (dry mouth, difficulty swallowing, thirst) are classic peripheral antimuscarinic effects
(b) Why given pre-operatively
To reduce salivary and bronchial secretions (preventing aspiration and easing intubation)
To prevent vagally-mediated reflex bradycardia during airway manipulation/anaesthetic induction
(c) Other drugs given pre-operatively
Benzodiazepines (e.g., Midazolam) — for anxiolysis/sedation
Opioids (e.g., Fentanyl, Morphine) — for analgesia and to reduce anaesthetic requirement
Antiemetics (e.g., Ondansetron) — to prevent postoperative nausea/vomiting
H2 blockers/PPIs (e.g., Ranitidine) — to reduce gastric acidity and aspiration risk
