Anaes SAQs · Anaesthetic adjuncts

Ephedrine — pharmacology and perioperative use

Final SAQ — ephedrine as the natural Ephedra alkaloid and mixed-acting sympathomimetic; dominant indirect noradrenaline-release mechanism with weak direct alpha-1/beta-1/beta-2 agonism (taught pharmacology); raises both blood pressure and heart rate; crosses the placenta so displaced by phenylephrine in obstetrics on umbilical-artery pH grounds (Lee 2002, WMD +0.03, no difference in true acidosis or Apgar); tachyphylaxis from noradrenaline store depletion; amphetamine cross-reactivity (Sainz-Pastor 2026); niche role in hypotension with bradycardia; delirium-null versus norepinephrine in older adults (Dong 2026); cost/environment profile (Parkinson 2026).