Which of the following drugs was most likely administered to the patient who developed muscle rigidity, tachycardia, and high fever during surgery?

Correct Answer: C

Rationale: The correct answer is C, Dantrolene. The patient's symptoms indicate malignant hyperthermia, a life-threatening reaction to certain anesthetics like succinylcholine. Dantrolene is the specific antidote for malignant hyperthermia, as it inhibits muscle contraction and lowers body temperature. Succinylcholine (A) can trigger malignant hyperthermia, while cisatracurium (B) and vecuronium (D) are non-depolarizing neuromuscular blocking agents unlikely to cause these symptoms.

Correct Answer: A

Rationale: The correct answer is A: Tubocurarine. Tubocurarine is a non-depolarizing neuromuscular blocking agent that can cause histamine release, leading to bronchoconstriction, which is dangerous for a patient with chronic obstructive pulmonary disease (COPD) and a heavy smoker undergoing major surgery. Glycopyrrolate (B) is a muscarinic antagonist that can be used to reduce secretions during surgery. Clonidine (C) is an alpha-2 adrenergic agonist that can help with perioperative hypertension. Vecuronium (D) is a non-depolarizing neuromuscular blocking agent, like tubocurarine, but it does not cause histamine release, making it a safer option for this patient.

Correct Answer: B

Rationale: The correct answer is B: Baclofen. Baclofen is a muscle relaxant commonly used to treat spasticity in conditions such as multiple sclerosis or spinal cord injuries. This drug would be appropriate for a patient experiencing muscle spasticity. Phenobarbital (A) is a barbiturate used for seizures, not muscle relaxation. Tubocurarine (C) and Succinylcholine (D) are neuromuscular blocking agents used for muscle paralysis during surgery, not for muscle spasticity. Therefore, Baclofen is the most appropriate choice for this patient.

Correct Answer: B

Rationale: The correct answer is B: Valproic acid. This drug is commonly used to treat bipolar disorder, which is characterized by mood swings. Valproic acid helps stabilize mood and prevent manic episodes. Lamotrigine (A) is used for bipolar disorder but is less effective for acute mania. Clonazepam (C) is used for anxiety and seizures, not bipolar disorder. Gabapentin (D) is primarily used for nerve pain and seizures, not bipolar disorder. Therefore, based on the context of the question, Valproic acid is the most likely drug she was taking.

Correct Answer: D

Rationale: The correct answer is D: Pancreatitis. During therapy, certain medications can cause pancreatitis due to their toxic effects on the pancreas. This can lead to inflammation of the pancreas, resulting in symptoms such as severe abdominal pain, nausea, and vomiting. Pancreatitis is a serious condition that requires immediate medical attention. Rationale: - A (Macrocytic anemia): This adverse effect is more commonly associated with deficiencies in vitamin B12 or folic acid, not typically caused by medications during therapy. - B (Hallucinations): Hallucinations are more likely to occur as a side effect of certain psychiatric medications or in cases of substance abuse, rather than during general therapy. - C (Liver cirrhosis): Liver cirrhosis is a long-term consequence of chronic liver damage, often due to alcohol abuse or viral hepatitis, not typically a direct adverse effect of therapy.