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Difficulty: MediumCardiovascular System

Match each cardiovascular medication used in the management of arrhythmias and other cardiac conditions with its most characteristic adverse effect profile.

  • AmiodaronePulmonary toxicity, thyroid dysfunction, and hepatotoxicity
  • ProcainamideDrug-induced lupus erythematosus with positive anti-histone antibodies
  • AdenosineTransient atrioventricular block, flushing, and chest pain
  • SotalolDose-dependent QT interval prolongation and torsades de pointes
  • VerapamilConstipation, gingival hyperplasia, and negative inotropy

Answer

Amiodarone matches with pulmonary/thyroid/hepatic toxicity. Procainamide matches with drug-induced lupus. Adenosine matches with transient AV block/flushing. Sotalol matches with QT prolongation/torsades de pointes. Verapamil matches with constipation/gingival hyperplasia/negative inotropy.
Each cardiovascular medication has a unique, high-yield adverse effect profile that is heavily tested on the USMLE Step 2 CK. Amiodarone is famous for its wide-ranging tissue toxicities (lungs, liver, thyroid) due to its lipophilic nature and iodine content. Procainamide is a classic cause of drug-induced lupus. Adenosine administration is distinctly known for causing a brief period of asystole or AV block accompanied by severe flushing and chest discomfort. Sotalol carries a significant risk of QT prolongation leading to torsades de pointes. Verapamil's blockade of calcium channels commonly results in severe constipation and can depress cardiac contractility.

Step-by-Step Solution

1
Analyze Amiodarone
Identified as a Class III agent known for multi-organ tissue toxicity.
Recognizing the broad side effect profile (lungs, thyroid, liver) is essential for monitoring patients on chronic amiodarone therapy.
2
Analyze Procainamide
Matched with drug-induced lupus erythematosus.
Class IA agents (along with hydralazine and isoniazid) are the classic culprits for drug-induced lupus, confirmed by positive anti-histone antibodies.
3
Analyze Adenosine
Matched with transient AV block, flushing, and chest pain.
Its ultrashort half-life and mechanism of hyperpolarizing the AV node cause these brief, uncomfortable symptoms during administration for supraventricular tachycardia.
4
Analyze Sotalol
Matched with dose-dependent QT prolongation and torsades de pointes.
As a Class III agent, it delays repolarization (prolonged QT), which increases the risk of early afterdepolarizations and polymorphic ventricular tachycardia.
5
Analyze Verapamil
Matched with constipation, gingival hyperplasia, and negative inotropy.
Calcium channel blockade affects gastrointestinal smooth muscle motility and myocardial contractility, making it contraindicated in decompensated heart failure.

Key Concept

Adverse effect profiles of cardiovascular medications (antiarrhythmics and calcium channel blockers).
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Topics

Cardiovascular System

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