NAPLEX Quiz
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FOUNDATIONAL KNOWLEDGE FOR PHARMACY PRACTICE
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A 62-year-old female (weight 75 kg, height 166 cm) with chronic atrial fibrillation is treated with diltiazem and metoprolol and presents with dizziness and near-syncope. Current medications: diltiazem extended-release 240 mg by mouth daily, metoprolol tartrate 50 mg by mouth twice daily, apixaban 5 mg by mouth twice daily. Vitals: heart rate 42 beats/min, blood pressure 92/56 mmHg. Labs: serum creatinine 0.9 mg/dL, aspartate aminotransferase 20 U/L, alanine aminotransferase 18 U/L. Allergies: none. Therapeutic goal: adequate rate control without symptomatic bradycardia. Which pharmacodynamic effect is responsible for the patient's symptoms?
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