Muscle relaxants: sugammadex and hormonal contraception: 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 · Muscle relaxants: sugammadex and hormonal contraception

Sample item

A woman using an oral contraceptive pill receives sugammadex to reverse rocuronium. What advice should be given?

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

The answer and the reasoning

A. Use additional non-hormonal contraception for 7 days, as if a pill had been missed

Sugammadex can bind progesterone and may reduce its levels, so its administration is treated like a missed dose of a hormonal contraceptive. Women are advised to follow the missed-dose instructions and use a non-hormonal back-up method for 7 days. Patients using oral or other hormonal contraceptives should be warned before discharge.

Option by option

  • A. Use additional non-hormonal contraception for 7 days, as if a pill had been missed (correct)

    Correct. Sugammadex is regarded as equivalent to a missed pill, so back-up contraception is advised.

  • B. Stop the pill permanently

    There is no need to discontinue the pill permanently.

  • C. Double the next pill dose

    Doubling the next dose is not advised.

  • D. No special advice is needed

    Counselling is needed because of the binding of progesterone.

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.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Use additional non-hormonal contraception for 7 days, as if a pill had been missed. Sugammadex can bind progesterone and may reduce its levels, so its administration is treated like a missed dose of a hormonal contraceptive.

Why is "Stop the pill permanently" not the answer?

There is no need to discontinue the pill permanently.

Why is "Double the next pill dose" not the answer?

Doubling the next dose is not advised.

Why is "No special advice is needed" not the answer?

Counselling is needed because of the binding of progesterone.

What concept does this question test?

It tests Muscle relaxants: sugammadex and hormonal contraception in Anaesthesia. Women are advised to follow the missed-dose instructions and use a non-hormonal back-up method for 7 days. Patients using oral or other hormonal contraceptives should be warned before discharge.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Muscle relaxants: sugammadex and hormonal contraception?

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.