Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

What medication should be administered when a patient develops ventricular arrhythmias after accidental IV administration of bupivacaine?

1. Amiodarone

2. Diphenhydramine

3. Adenosine

4. Lidocaine

The correct answer is: Amiodarone

When a patient develops ventricular arrhythmias following the accidental intravenous administration of bupivacaine, administering amiodarone is the most appropriate choice. Amiodarone is a Class III antiarrhythmic medication commonly used to manage various types of ventricular arrhythmias, including those that may arise due to high levels of local anesthetics like bupivacaine, which can have cardiotoxic effects. In the context of bupivacaine's properties, it can lead to ventricular arrhythmias because it can block sodium channels in the cardiac myocytes, disrupting the normal electrical conduction within the heart. Amiodarone counteracts these arrhythmias by prolonging the action potential and refractory period in the myocardial tissue. Additionally, it has multiple mechanisms of action that stabilize the cardiac membrane and help restore normal rhythm. Other options, although they have their uses, are not suitable for treating ventricular arrhythmias resulting from bupivacaine toxicity. Diphenhydramine primarily acts as an antihistamine and would not effectively address the underlying cardiac disturbances. Adenosine is typically used for specific types of supraventricular tachycardia, but it is less effective for ventricular issues. In this scenario, lid