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Pharmacology C.V.S 327c0bd4

For a patient of hypertension on metoprolol, verapamil was given. This will result in:

A
Atrial fibrillation
B
Bradycardia with AV block
C
Torsades de pointes
D
Tachycardia
High-Yield Explanation
Ans. B. Bradycardia with AV block* Impulse generation in theSA node and conduction in AV node are blocked by all calcium channel blockers* Sodium channel block is modest with verapamil, and still less marked with diltiazem. It is negligible with dihydropyridines.* Verapamil and diltiazem block conduction in cardiac calcium-dependent cells (AV node) more selectively than do the dihydropyridines.* Metoprolol is selective (b1 blocker which blocks b1 receptors in heart and as a result decreases the heart rate.* So combination of metoprolol with verapamil can cause marked decrease in heart rate along with AV block effect. This combination is irrational.

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