Which medication is contraindicated in a patient with a wide complex tachycardia?

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Multiple Choice

Which medication is contraindicated in a patient with a wide complex tachycardia?

Explanation:
When a wide complex tachycardia is encountered, assume ventricular tachycardia until proven otherwise. In VT, the rhythm originates in the ventricles, not the AV node, so slowing AV nodal conduction won’t terminate the tachycardia and can worsen the patient’s hemodynamics. Diltiazem is a calcium channel blocker that reduces AV nodal conduction and can cause hypotension and cardiovascular collapse in VT, making it contraindicated. Safer choices for VT are antiarrhythmics that act on ventricular tissue, such as amiodarone or lidocaine. Adenosine is mainly for SVT with AV nodal reentry and is not effective for VT and can be harmful if the rhythm is VT.

When a wide complex tachycardia is encountered, assume ventricular tachycardia until proven otherwise. In VT, the rhythm originates in the ventricles, not the AV node, so slowing AV nodal conduction won’t terminate the tachycardia and can worsen the patient’s hemodynamics. Diltiazem is a calcium channel blocker that reduces AV nodal conduction and can cause hypotension and cardiovascular collapse in VT, making it contraindicated. Safer choices for VT are antiarrhythmics that act on ventricular tissue, such as amiodarone or lidocaine. Adenosine is mainly for SVT with AV nodal reentry and is not effective for VT and can be harmful if the rhythm is VT.

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