Concerning drugs and arrhythmias

Which of the following medications have the highest risk of producing the arrhythmia shown in the ECG below when the patient is also taking amiodarone?

Fig: An ECG report showing the arrhythmia
  1. Flecainide
  2. Phenytoin
  3. Propafenone
  4. Chloroquine
  5. Lidocaine






ANSWER
The correct answer is E


Explanation
Common clinical features in drug-induced torsade de pointes include hypokalemia and cycle-length prolongation just prior to initiation of the arrhythmia.

Among these agents, sotalol, which is a class III agent, has the highest risk of producing torsades, which is a polymorphic, pause-dependent ventricular tachycardia causing syncope and sudden cardiac death.

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