An 72-year-old man is brought to the emergency department after a syncopal episode. He has had no chest pain or dyspnea but he has constipation of recent onset. He was hospitalized 3weeks ago for atrial fibrillation was discharged home with oral medications after appropriate management. Medical history is also significant for hypertension. Blood pressure is 105/60 mm Hg and pulse is 50/min. Examination reveals bilaterally decreased breath sounds, no wheezing, and normal heart sounds. ECG shows new-onset second-degree atrioventricular block. Which of the following drugs is the most likely cause of his current condition?

Question

An 72-year-old man is brought to the emergency department after a syncopal episode.  He has had no chest pain or dyspnea but he has constipation of recent onset.  He was hospitalized 3weeks ago for atrial fibrillation was discharged home with oral medications after appropriate management.  Medical history is also significant for hypertension.  Blood pressure is 105/60 mm Hg and pulse is 50/min.  Examination reveals bilaterally decreased breath sounds, no wheezing, and normal heart sounds.  ECG shows new-onset second-degree atrioventricular block.  Which of the following drugs is the most likely cause of his current condition?

Quizplus · Accepted Answer

Eductional Objective: Common adverse effects of nondihydropyridine calcium channel blockers (eg, diltiazem, verapamil) include constipation, bradycardia, atrioventricular block (negative chronotropic effect), and worsening of heart failure in patients with left ventricular systolic dysfunction (negative inotropic effect).

An 72-Year-Old Man Is Brought to the Emergency Department After