Which of the following drugs is used for termination as well as prophylaxis of paroxysmal supraventricular tachycardia ?
**Core Concept**
The question is testing the student's knowledge of antiarrhythmic drugs, specifically those used in the management of paroxysmal supraventricular tachycardia (PSVT). PSVT is a type of abnormal heart rhythm characterized by a rapid heart rate, originating from the supraventricular region of the heart.
**Why the Correct Answer is Right**
Adenosine is the correct answer because it is a potent vasodilator that works by transiently blocking AV nodal conduction, thereby terminating PSVT. This occurs through the activation of A2A receptors on the AV node, leading to a decrease in calcium influx and a subsequent decrease in AV nodal conduction velocity. Adenosine is also used as a prophylactic agent to prevent recurrences of PSVT.
**Why Each Wrong Option is Incorrect**
* **Option A:** Digoxin is not the first-line treatment for PSVT and can actually worsen the condition by increasing AV nodal conduction velocity.
* **Option B:** Magnesium sulfate is used to treat torsades de pointes and other types of ventricular arrhythmias, but it is not the primary treatment for PSVT.
* **Option C:** Quinidine is a class IA antiarrhythmic drug that is used to treat various types of arrhythmias, but it is not the preferred choice for PSVT due to its potential for proarrhythmic effects.
**Clinical Pearl / High-Yield Fact**
Adenosine has a very short half-life (less than 10 seconds), which means it must be administered as a rapid bolus to be effective in terminating PSVT. This unique pharmacokinetic profile makes adenosine an ideal choice for this application.
**Correct Answer:** D. Adenosine