Which statement regarding a pregnant patient abusing cocaine is TRUE?

Which statement regarding a pregnant patient abusing cocaine is TRUE?

• A. Hypotension is common with the rapid sequence induction of general anesthesia in the acutely intoxicated patient
• B. The MAC for general anesthetics is increased in chronic cocaine addicts
• C. Hypertension is common with the induction of epidural anesthesia for labor
• D. Some states consider in utero drug exposure to be a form of child abuse and require physicians to report these patients

Answer: (D)

Mandatory reporting of in utero cocaine exposure is required in some states. This makes the statement about reporting true, because physicians may be obligated to report drug exposure during pregnancy to child protective services. In contrast, acutely intoxicated cocaine patients typically have hypertension and tachycardia, so hypotension during rapid-sequence induction is not the usual pattern. Chronic cocaine use does not reliably increase anesthetic requirements; MAC is not consistently higher and may be unchanged or reduced. Epidural anesthesia for labor often causes hypotension due to sympathetic blockade, not hypertension, so that statement is not correct.

Mandatory reporting of in utero cocaine exposure is required in some states. This makes the statement about reporting true, because physicians may be obligated to report drug exposure during pregnancy to child protective services. In contrast, acutely intoxicated cocaine patients typically have hypertension and tachycardia, so hypotension during rapid-sequence induction is not the usual pattern. Chronic cocaine use does not reliably increase anesthetic requirements; MAC is not consistently higher and may be unchanged or reduced. Epidural anesthesia for labor often causes hypotension due to sympathetic blockade, not hypertension, so that statement is not correct.