Correct Option C: Amiodarone

This patient with a history of atrial fibrillation is most likely suffering from the adverse effects of amiodarone.
Amiodarone belongs to the class III antiarrhythmic and has the properties of all four classes.
It acts at the plateau phase of the action potential and lengthens the effective refractory period (ERP).
Other side effects include:
- Photosensitivity
- Skin discolouration
- Corneal deposits
- Thyroid dysfunction
- Pulmonary fibrosis
- Torsades de pointes

System	Adverse effect	Baseline	Follow-up
Cardiac	QT prolongation SAVAV block	ECG	Every $6-12$ months
Hepatic	AST/ALT elevation	AST/ALT	Every 6 months
Ophthalmologic	Comeal deposition Optic neuropathy	Eye examination	As needed
Pulmonology	Pulmonary fibrosis	Pulmonary function test Chest X-ray	Every 6-12 months
Thyroid	Hypothyroidism Hyperthyroidism	Thyroid function test	Every 6 months

Baseline	Every 6 month	Every 6-12 month	As needed
ECG TSH AST/ALT Chest X-ray PFT Eye exam	TSH AST/ALT	ECG Chest X-ray PFT Eye exam	Skin exam

It is among the most effective drugs for managing paroxysmal atrial fibrillation. It can also be used for ventricular arrhythmias.

Incorrect Options:

Option A - Propranolol:

Propranolol is a non-selective β-blocker that belongs to the class II antiarrhythmic and reduces the rate of SA node depolarisation and increases the PR interval without any effect on ERP.
It also slows the AV node’s conduction, making it suitable for rate control in patients with atrial flutter or fibrillation.
Propranolol is contraindicated in patients with asthma because it causes bronchospasm.
Other side effects include:
- Myocardial depression
- Bradycardia
- Impotence
- Fatigue
- Depression

Option B - Adenosine:

Adenosine is a first-line agent in managing supraventricular tachycardia (SVT).
It decreases AV node conduction by hyperpolarization of the cell.
Common side effects include:
- Flushing
- Hypotension
- Bronchospasm
- Chest pain
It is contraindicated in patients with asthma.

Option D - Verapamil:

Verapamil is a calcium channel blocker that belongs to the class IV antiarrhythmic.
Verapamil is a calcium channel blocker which usually affects the PR interval, so it would not cause QT interval prolongation.
Common side effects include:
- Bradycardia
- Heart block
- Constipation
- Hypotension

Verapamil is used for rate control in patients with atrial fibrillation.

All India Neet Ss Grand Test 1 2Nd Aug 2023 August 2023 Entire Ss Syllabus 1

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