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Question 442
Pharmacology → General
Classification
Question
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A patient receiving imipramine requires an anaesthetic. Which pair of cardiovascular complications is specifically described as being increased when anaesthetic agents are administered during imipramine therapy?
Question Stem
Select the single best answer.
Options
A
Hypertension and reflex tachycardia
B
Bradycardia and systemic hypertension
C
Bronchospasm and pulmonary hypertension
D
Arrhythmias and hypotension
E
Heart failure and peripheral vasoconstriction
Explanation
Anaesthetics administered during imipramine therapy may increase the risk of arrhythmias and hypotension. This is clinically important because tricyclic antidepressants have cardiovascular toxicity and a relatively low safety margin.
Option Validity
A) The recognised interaction during anaesthesia in a patient taking imipramine is arrhythmias with hypotension rather than hypertension with reflex tachycardia.
B) Systemic hypertension is not the cardiovascular interaction associated with this interaction.
C) Bronchospasm and pulmonary hypertension are not the paired complications associated with this interaction.
E) Heart failure with peripheral vasoconstriction is not the characteristic anaesthetic interaction with imipramine.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 12: Pharmacology. Antidepressant Drugs, pp.346–347.