Which drug is most associated with tachycardia due to autonomic ganglia stimulation?

Which drug is most associated with tachycardia due to autonomic ganglia stimulation?

• A. Mivacurium
• B. Pancuronium
• C. Atracurium
• D. Vecuronium

Answer: (B)

Pancuronium has a strong vagolytic effect, meaning it blocks acetylcholine action at cardiac muscarinic receptors (primarily M2 receptors). The heart is normally kept in check by parasympathetic (vagal) tone; when this vagal influence is blocked, the heart rate rises. This makes tachycardia a prominent and characteristic effect of pancuronium, especially under light anesthesia or in patients with higher vagal tone. Other agents listed have different cardiovascular profiles: some can release histamine and cause hypotension with minimal tachycardia, and others are relatively hemodynamically stable with little impact on heart rate. Among them, pancuronium stands out for tachycardia due to its vagolytic action.

Pancuronium has a strong vagolytic effect, meaning it blocks acetylcholine action at cardiac muscarinic receptors (primarily M2 receptors). The heart is normally kept in check by parasympathetic (vagal) tone; when this vagal influence is blocked, the heart rate rises. This makes tachycardia a prominent and characteristic effect of pancuronium, especially under light anesthesia or in patients with higher vagal tone.

Other agents listed have different cardiovascular profiles: some can release histamine and cause hypotension with minimal tachycardia, and others are relatively hemodynamically stable with little impact on heart rate. Among them, pancuronium stands out for tachycardia due to its vagolytic action.