Pharmacology: esmolol: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Pharmacology: esmolol

Sample item

Why is esmolol suitable for short-term control of heart rate during anaesthesia?

AIt is metabolised in the liver over many hoursBIt is a cardioselective beta-1 blocker metabolised by red cell esterases, with a half-life of about 9 minutesCIt is a long-acting non-selective beta blockerDIt is a calcium channel blocker

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. It is a cardioselective beta-1 blocker metabolised by red cell esterases, with a half-life of about 9 minutes

Esmolol is an ultra-short-acting cardioselective beta-1 antagonist, hydrolysed by red cell esterases to inactive products. Its half-life is about 9 minutes, so its effect wears off quickly after stopping the infusion. It blunts the pressor response to intubation and treats perioperative tachycardia.

Option by option

A. It is metabolised in the liver over many hours
Hepatic metabolism is not the main route.
B. It is a cardioselective beta-1 blocker metabolised by red cell esterases, with a half-life of about 9 minutes (correct)
Correct. Rapid esterase metabolism gives a short, controllable effect.
C. It is a long-acting non-selective beta blocker
It is cardioselective and short acting, unlike propranolol.
D. It is a calcium channel blocker
It is a beta blocker and not a calcium channel blocker.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is B, It is a cardioselective beta-1 blocker metabolised by red cell esterases, with a half-life of about 9 minutes. Esmolol is an ultra-short-acting cardioselective beta-1 antagonist, hydrolysed by red cell esterases to inactive products.

Why is "It is metabolised in the liver over many hours" not the answer?

Hepatic metabolism is not the main route.

Why is "It is a long-acting non-selective beta blocker" not the answer?

It is cardioselective and short acting, unlike propranolol.

Why is "It is a calcium channel blocker" not the answer?

It is a beta blocker and not a calcium channel blocker.

What concept does this question test?

It tests Pharmacology: esmolol in Anaesthesia. Its half-life is about 9 minutes, so its effect wears off quickly after stopping the infusion. It blunts the pressor response to intubation and treats perioperative tachycardia.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Pharmacology: esmolol?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.