Drugs in pregnancy: beta-agonist tocolysis: practice question

A Pharmacology 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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Pharmacology · Drugs in pregnancy: beta-agonist tocolysis

Sample item

A woman at 30 weeks in preterm labour is given an intravenous beta-2 agonist infusion. Several hours later she is breathless, with tachycardia and bibasal crackles. Which adverse effect has occurred?

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

The answer and the reasoning

A. Pulmonary oedema

Beta-2 agonist tocolytics such as ritodrine, terbutaline and salbutamol cause maternal tachycardia, tremor, hypokalaemia and hyperglycaemia, and can cause pulmonary oedema, especially with fluid overload. They are avoided in women with heart disease.

Option by option

  • A. Pulmonary oedema (correct)

    Correct. Beta-agonist tocolysis can cause maternal pulmonary oedema.

  • B. Oligohydramnios

    Oligohydramnios is associated with indomethacin and ACE inhibitors.

  • C. Premature closure of the fetal ductus arteriosus

    Premature ductal closure is a fetal effect of indomethacin.

  • D. Hypermagnesaemia

    Hypermagnesaemia follows magnesium sulphate therapy, not beta-agonists.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is A, Pulmonary oedema. Beta-2 agonist tocolytics such as ritodrine, terbutaline and salbutamol cause maternal tachycardia, tremor, hypokalaemia and hyperglycaemia, and can cause pulmonary oedema, especially with fluid overload.

Why is "Oligohydramnios" not the answer?

Oligohydramnios is associated with indomethacin and ACE inhibitors.

Why is "Premature closure of the fetal ductus arteriosus" not the answer?

Premature ductal closure is a fetal effect of indomethacin.

Why is "Hypermagnesaemia" not the answer?

Hypermagnesaemia follows magnesium sulphate therapy, not beta-agonists.

What concept does this question test?

It tests Drugs in pregnancy: beta-agonist tocolysis in Pharmacology. They are avoided in women with heart disease.

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 Drugs in pregnancy: beta-agonist tocolysis?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.