A 52-year-old man is admitted to the Emergency Department.
He was found collapsed by neighbours. An ECG on arrival shows torsades de pointes. Which one of his medications is most likely to have contributed to this presentation?- A- Bisoprolol.
- B- Cimetidine.
- C- Risperidone.
- D- Phenytoin.
- E- Doxycycline..
Based on the provided information and the potential for QT prolongation, the most likely medication to have contributed to the patient's torsades de pointes is: D. Phenytoin
Here's the reasoning behind this:
- Torsades de pointes:
This is a type of polymorphic ventricular tachycardia associated with QT prolongation on the ECG.
- QT prolongation:
Some medications can prolong the QT interval on the ECG, increasing the risk of torsades de pointes.
- Drug-induced torsades de pointes:
Several medications, including antiarrhythmics, antipsychotics, and antibiotics, can cause this condition.
Analysis of the options:
A. Bisoprolol:
While bisoprolol can theoretically prolong the QT interval, it is not a common culprit for torsades de pointes.
B. Cimetidine:
Cimetidine can prolong the QT interval, but it is less likely than phenytoin to cause torsades de pointes.
C. Risperidone:
Risperidone has been linked to QT prolongation, but the risk is considered low.
E. Doxycycline:
Doxycycline is not known to cause QT prolongation or torsades de pointes.
Therefore, based on the information provided, phenytoin is the most likely medication to have contributed to the patient's presentation of torsades de pointes.
Disclaimer:
This is for educational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment of medical conditions.
It's important to note that other factors, such as electrolyte imbalances or underlying medical conditions, could also contribute to torsades de pointes. A thorough medical evaluation is necessary to determine the exact cause in this case.
