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1. A 65-year-old male patient with a history of
hypertension, diabetes, and coronary artery disease is
scheduled for a coronary artery bypass graft surgery. He is
taking metoprolol, lisinopril, aspirin, and metformin.
Which of the following drugs should be avoided in his
anesthesia induction?
a) Fentanyl
b) Propofol
c) Ketamine*
d) Midazolam
Rationale: Ketamine is a sympathomimetic drug that
increases blood pressure, heart rate, and myocardial oxygen
demand. It can cause myocardial ischemia and arrhythmias
in patients with coronary artery disease. Fentanyl, propofol,
and midazolam are more suitable for this patient as they
have cardioprotective effects.
2. A 25-year-old female patient with a history of asthma is
undergoing a laparoscopic cholecystectomy. She is allergic
to penicillin and sulfonamides. Which of the following
drugs should be used with caution in her anesthesia
maintenance?
a) Isoflurane
b) Sevoflurane
c) Desflurane*
d) Nitrous oxide
Rationale: Desflurane is a potent bronchodilator, but it can
also cause airway irritation and coughing during inhalation.
It can trigger bronchospasm in patients with asthma,Â
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