1. A 65-year-old male patient with a history of

hypertension, diabetes, and coronary artery disease is

scheduled for a coronary artery bypass graft surgery. He is

taking metoprolol, lisinopril, aspirin, and metformin.

Which of the following drugs should be avoided in his

anesthesia induction?

a) Fentanyl

b) Propofol

c) Ketamine*

d) Midazolam

Rationale: Ketamine is a sympathomimetic drug that

increases blood pressure, heart rate, and myocardial oxygen

demand. It can cause myocardial ischemia and arrhythmias

in patients with coronary artery disease. Fentanyl, propofol,

and midazolam are more suitable for this patient as they

have cardioprotective effects.

2. A 25-year-old female patient with a history of asthma is

undergoing a laparoscopic cholecystectomy. She is allergic

to penicillin and sulfonamides. Which of the following

drugs should be used with caution in her anesthesia

maintenance?

a) Isoflurane

b) Sevoflurane

c) Desflurane*

d) Nitrous oxide

Rationale: Desflurane is a potent bronchodilator, but it can

also cause airway irritation and coughing during inhalation.

It can trigger bronchospasm in patients with asthma,