For a patient of hypertension on metoprolol, verapamil was given. This will result in:
Ans. B. Bradycardia with AV block* Impulse generation in theSA node and conduction in AV node are blocked by all calcium channel blockers* Sodium channel block is modest with verapamil, and still less marked with diltiazem. It is negligible with dihydropyridines.* Verapamil and diltiazem block conduction in cardiac calcium-dependent cells (AV node) more selectively than do the dihydropyridines.* Metoprolol is selective (b1 blocker which blocks b1 receptors in heart and as a result decreases the heart rate.* So combination of metoprolol with verapamil can cause marked decrease in heart rate along with AV block effect. This combination is irrational.
Atrial fibrillation
Bradycardia with AV block
Torsades de pointes
Tachycardia
C.V.S