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Pharmacology C.N.S d750eb78

Which of the following anaesthetic agent leads to increase in ICT

A
Thiopentone
B
Ketamine
C
Propofol
D
Sevoflurane
High-Yield Explanation
(Ref: Katzung, 11th ed. pg. 437; KDT, 6th ed. pg. 376)* Ketamine is the only intravenous anesthetic that possesses analgesic properties and produces cardiovascular stimulation.* It causes "dissociative anesthesia" which is characterized by profound analgesia, immobility, amnesia and feeling of dissociation from ones' own body and the surrounding.* It has bronchodilator effect therefore considered as Induction agent of choice in asthma patient.* In addition, it also causes:# Hallucination# Delusion and illusion# Profound analgesia* Ketamine increases all pressures like:# BP (hypertension), Heart rate, Cardiac output# Intracranial tension (it increases cerebral blood flow)# Intraocular pressure (IOP)* It is contraindicated in intracerebral mass/haemorrhage, MI, schizophrenia, EpilepsyMOA of Ketamine:* It acts by blocking NMDA receptor (of glutamate).Side effect of other given options:* Propofol: Apnea, Decreases BP and HR* Thiopentone: Laryngospasm, Shivering & Delirium* Etomidate: Adrenocortical suppression

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