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Pharmacology

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CNS Part-1

Question
42 out of 58
 

A patient has periodic episodes of paroxysmal supraventricular tachycardia. Which of the following would be most suitable for outpatient prophylaxis?



A Adenosine
B Lidocaine

C Nifedipine
D Verapamil

Ans. D Verapamil

a. Verapamil, a non dihydropyridine ca channel blocker (ccb), depresses both the s-a node and the a-v node and would be effective for prophylaxis of paroxysmal atrial or supraventricular tachycardia. Nifedipine, the prototypic dihydropyridine ccb, has little effect on svt.

b. If we chose a fast-/immediate-acting dosage form of nifedipine, we would probably trigger substantial reflex cardiac stimulation.

c. The increased sympathetic tone to the heart could worsen the psvt. (and, although nitroglycerin is mainly a venodilator, it too could trigger reflex cardiac activation and worsen matters.)

d. Lidocaine and adenosine are parenteral drugs with short half-lives and, thus, are not suitable for prophylactic therapy.

CNS Part-1 Flashcard List

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