Antiemetics, Autacoids, Perioperative Anaphylaxis, and Coagulation Pharmacology — WACS Viva & Clinical Scenarios (Pharmacology and Applied Pharmacology)

Exam-style antiemetics, autacoids, perioperative anaphylaxis, and coagulation pharmacology viva scenarios with examiner probes and model answers for…

Scenarios covered

• SCENARIO 1: Two minutes following intravenous administration of cefuroxime and atracurium during induction of general anaesthesia, a 35-year-old female develops profound hypotension (BP 48/20 mmHg), severe bronchospasm with high peak airway pressures, and generalized cutaneous erythema. Formulate your immediate pharmacological management protocol.
• SCENARIO 2: A 28-year-old female with a history of severe motion sickness and previous postoperative vomiting is scheduled for diagnostic laparoscopy. Design a combination antiemetic strategy explaining the mechanisms, receptor sites, and timing of administration for each agent.
• SCENARIO 3: A 65-year-old male on maintenance warfarin therapy (INR 4.2) requires emergency laparotomy for strangulated bowel obstruction. Outline the pharmacological options available in a resource-limited West African setting to achieve rapid haemostatic reversal.
• SCENARIO 4: During cardiopulmonary bypass or major vascular surgery, a patient receives 300 units/kg of unfractionated heparin. Describe the mechanism of action of heparin, monitoring with activated clotting time, and exact dosing and hazards of protamine sulphate reversal.