DSSSB 6 September 2024
Pharmacology
Easy
Which is the drug of choice to convert paroxysmal supraventricular tachycardia to normal sinus rhythm?
Appeared in: DSSSB 6 September 2024
Explanation
- Adenosine is the first-line pharmacological agent recommended for terminating stable, narrow-complex supraventricular tachycardia (SVT).
- Its primary mechanism is slowing conduction through the atrioventricular (AV) node, which interrupts the re-entry pathway responsible for most cases of PSVT.
- Adenosine has an extremely short half-life (less than 10 seconds), making its action rapid and transient. This allows for quick conversion of the rhythm while minimizing the duration of potential side effects.
Why Other Options Were Wrong
- Option A: Atropine is an anticholinergic drug that increases the heart rate by blocking vagal effects on the SA and AV nodes. Administering it would worsen the tachycardia.
- Option B: Adrenaline (epinephrine) is a potent catecholamine that stimulates the heart, increasing its rate, contractility, and conductivity. This would exacerbate the PSVT.
- Option C: Dopamine is a vasopressor and inotrope used to increase blood pressure and cardiac output. It does not have a primary role in converting tachyarrhythmias and can sometimes increase heart rate.
Related Visual
Clinical Relevance
- Nursing practice connection: Prioritize focused assessment, early escalation, and real-time monitoring when managing Pharmacological treatment of Paroxysmal Supraventricular Tachycardia (PSVT) in acute care settings.
- The nurse's role in administering adenosine is critical. Due to the drug's very short half-life, it requires a rapid IV push followed immediately by a saline flush to be effective.
- Continuous ECG monitoring is a vital nursing responsibility during administration to observe for the expected therapeutic effect (conversion to sinus rhythm) and the common, transient side effect of asystole.
- Patient education and reassurance are key. The nurse must prepare the patient for the common, uncomfortable sensations (flushing, chest pressure) to reduce anxiety.
How to Approach the Question
- First, identify the clinical condition presented in the question: Paroxysmal Supraventricular Tachycardia (PSVT).
- Next, understand the goal: to convert this rapid heart rhythm back to a normal sinus rhythm.
- Recall the first-line pharmacological treatment for stable PSVT. This is a key piece of knowledge in cardiac care.
- Evaluate the given options based on their primary mechanisms of action. Adenosine is known for its potent, short-acting AV nodal blocking effect.
- Eliminate the distractors. Atropine and Adrenaline both increase heart rate, making them incorrect. Dopamine is used for blood pressure support and is not a primary antiarrhythmic for PSVT.
Concept Tested & Keywords
- Concept Tested: Pharmacological treatment of Paroxysmal Supraventricular Tachycardia (PSVT)
- Stem keywords: drug of choice, paroxysmal supraventricular tachycardia, PSVT, normal sinus rhythm
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
QHshnKZqWEQ3BsAiQwgQ2a
Reference Book
E6 Pharmacology KD Tripathi Essentials 9e Part 2 p. 212-214
E6 Medicine Davidson Principles Practice 24e pp. 502-504, 501-503
Practise the full DSSSB 6 September 2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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