Family Nurse Practitioner Exam

Which medication should a patient with second-degree heart block avoid?

1. ACE inhibitors

2. Calcium channel blockers

3. Beta agonists

4. Antiplatelet agents

The correct answer is: Calcium channel blockers

In the context of second-degree heart block, the use of calcium channel blockers should generally be avoided due to their potential to further impair conduction through the AV node. Calcium channel blockers, particularly non-dihydropyridine types such as verapamil and diltiazem, can slow down heart rate and may exacerbate the block by further decreasing the speed of electrical impulses in the heart. This could lead to more severe bradycardia or even progression to a more complete block. Other medication classes listed have different implications. ACE inhibitors and antiplatelet agents typically do not have a direct impact on heart conduction and can be useful in managing comorbid conditions or preventing cardiovascular events. Beta agonists, while primarily used for conditions such as asthma or COPD, can also have varying effects on heart rate and contractility but are not usually contraindicated in the context of second-degree heart block, unless there are specific complications.