NBME 24 Sotalol (NBME Answers)

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Retired NBME 24 Answers

nbme24/Block 1/Question#34 (reveal difficulty score)
A 62-year-old man comes to the physician for ...
Sotalol 🔍 / 📺 / 🌳 / 📖
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submitted by ∗neonem(629)

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Sotalol is a type III antiarrhythmic (K+ channel-blocking) that also has beta-blocker activity (Type II antiarrhythmic). This explains the decreased heartrate and blood pressure (beta-1 blocking activity), with the QT prolongation - all type III AADs cause QT prolongation.

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abhishek021196 Would like to add that the IA antiarrythmics = Quinidine, Disopyramide, Procainamide also prolong QT interval and can lead to tosades de Pointes and they would most likely present with Cinchonism (headache, tinnitus with quinidine), reversible SLE-like syndrome (procainamide), HF (disopyramide), thrombocytopenia. The decreased HR and BP point towards Sotalol. +8

armageddon_oh Im glad you can regurgitate sketchy but none of those drugs were options here. It's as simple as which of these can cause torsades. +7

an_improved_me Lol why the salt ^? I'm sure to some people, this was a useful reminder of the side-effect profile of these drugs (spaced repetition), and was likely helpful for the poster (again, spaced repetition) Its all love! +15

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submitted by ∗madojo(212)

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-Adenosine decreases AV node conduction used in SVT, and its side effects include flushing, hypotension, chest pain, impending doom. -Flecainide is a Sodium channel blocker Class 1C with strong Na channel blockage and its contraindicated in structural and ischemic heart disease. -Phenytoin is an anti epileptic, associated with teratogenicity, p450 induction, osteopenia

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