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Torsades de pointes — FRCA Primary MCQ

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ModeratePharmacologyTorsades de pointesFRCA Primary

After QT-prolonging medication, a patient develops polymorphic ventricular tachycardia with a long QT interval. Which drug is most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Magnesium sulphate

Magnesium sulphate is first-line pharmacological treatment for torsades de pointes. Bupivacaine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Clopidogrel is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Flumazenil is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. Atropine is less appropriate because it would fit a different clinical clue or a separate anaesthetic problem. In Primary FRCA pharmacology, link the clinical effect to the receptor, distribution or elimination mechanism rather than memorising isolated facts.

Reference: Peck, Hill & Williams Pharmacology for Anaesthesia and Intensive Care; BNF; Primary FRCA textbooks