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General Medicine · Cardiology: pharmacological stress testing
Sample itemA 70-year-old man who cannot exercise because of severe arthritis has a myocardial perfusion scan with dipyridamole. During the test he develops wheeze and chest discomfort. Which drug should be given to reverse these effects?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Aminophylline
Dipyridamole blocks adenosine reuptake, so adenosine accumulates and causes vasodilation, bronchospasm and sometimes chest pain. Aminophylline antagonises adenosine receptors and reverses these effects, and caffeine must be avoided before the test for the same reason.
Option by option
A. Naloxone
Naloxone reverses opioid effects and has no action on adenosine.
B. Aminophylline (correct)
Correct. Aminophylline is an adenosine receptor antagonist and reverses the effects.
C. Esmolol
Esmolol is used to reverse dobutamine stress, not adenosine-mediated effects.
D. Atropine
Atropine reverses muscarinic effects such as vagal bradycardia, not adenosine effects.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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