MS-2268

You are a student observing a routine cholecystectomy procedure as part of your clinical placement in a general surgical unit. The patient is a 49-year-old woman with a medical history of asthma and current cholecystitis.

During the induction of anaesthesia, the patient’s vital signs rapidly deteriorate. Her blood pressure drops to 80/60mmHg, heart rate increases to 148bpm, and she requires increased ventilatory pressure. The anaesthetist suspects a drug reaction.

What is the primary biochemical agent responsible for this drug reaction, given the most likely mechanism?