Certified Registered Nurse Anesthetist (CRNA) Practice Exam

Which of these medications may require close monitoring for seizures as an adverse effect?

1. Clonidine

2. Esmolol

3. Mannitol

4. Heparin

The correct answer is: Esmolol

Esmolol is the medication that may require close monitoring for seizures as an adverse effect. It is a rapid-acting beta-blocker, and while it is primarily used for situations involving acute control of heart rate and blood pressure, it can have central nervous system effects in some patients, particularly if high doses are used or if there are predisposing factors such as renal impairment or concurrent use with other medications that lower seizure thresholds. Closer monitoring might be necessary in certain populations, especially those who have a history of seizures or are receiving concurrent agents known to lower seizure thresholds. The other medications listed tend to have different risk profiles. Clonidine, while it can cause sedation and hypotension, is less commonly associated with seizures. Mannitol, used as an osmotic diuretic, is more associated with fluid and electrolyte imbalances than seizures. Heparin, an anticoagulant, also does not commonly relate to seizure activity as an adverse effect. Thus, esmolol stands out as the medication requiring vigilance for the risk of seizures in specified clinical scenarios.