In adult stable really wide complex tachycardia, which medication is contraindicated?

• A. Amiodarone
• B. Calcium Chloride
• C. Sodium Bicarbonate
• D. Albuterol

Answer: (A)

The situation hinges on the risk of QT prolongation and the specific rhythm you’re dealing with. Amiodarone is a powerful antiarrhythmic that can prolong the QT interval. If the wide complex tachycardia is actually torsades de pointes or sits in a context of a long QT, giving amiodarone can worsen the arrhythmia instead of correcting it. In that scenario, magnesium sulfate and correction of electrolytes are preferred, and other targeted therapies would be used instead of amiodarone. The other options don’t address the underlying issue of QT-related arrhythmia in the same way, so they aren’t the best match for a situation where amiodarone would be contraindicated.