Intravenous and inhalational agents: ketamine salivation: 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 · Intravenous and inhalational agents: ketamine salivation

Sample item

A 5-year-old receives intramuscular ketamine for a burns dressing, and copious salivation threatens the airway. Which premedication would best have prevented this?

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

The answer and the reasoning

D. Glycopyrrolate

Ketamine increases salivary and bronchial secretions, and an antisialagogue such as glycopyrrolate or atropine is given beforehand. Midazolam reduces emergence phenomena but does not control secretions.

Option by option

  • A. Neostigmine

    Neostigmine is a cholinesterase inhibitor and would increase secretions.

  • B. Midazolam

    Midazolam reduces emergence reactions but does not dry secretions.

  • C. Ondansetron

    Ondansetron is an antiemetic with no effect on salivation.

  • D. Glycopyrrolate (correct)

    Correct. An antimuscarinic dries secretions, which ketamine increases.

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 D, Glycopyrrolate. Ketamine increases salivary and bronchial secretions, and an antisialagogue such as glycopyrrolate or atropine is given beforehand.

Why is "Neostigmine" not the answer?

Neostigmine is a cholinesterase inhibitor and would increase secretions.

Why is "Midazolam" not the answer?

Midazolam reduces emergence reactions but does not dry secretions.

Why is "Ondansetron" not the answer?

Ondansetron is an antiemetic with no effect on salivation.

What concept does this question test?

It tests Intravenous and inhalational agents: ketamine salivation in Anaesthesia. Midazolam reduces emergence phenomena but does not control secretions.

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 Intravenous and inhalational agents: ketamine salivation?

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.