A 55-year-old patient with acute anterior STEMI develops monomorphic ventricular tachycardia with a pulse and stable blood pressure. Which drug is the most appropriate first-line therapy according to current ACLS guidelines?

• A IV procainamide
• B IV sotalol
• C IV lidocaine
• D IV amiodarone ✓

Explanation

IV amiodarone is the first-line antiarrhythmic for stable monomorphic VT in the setting of myocardial ischemia/infarction. Lidocaine (class IB) has largely been superseded by amiodarone in guidelines. Procainamide is an alternative but is less favored. Amiodarone's broad-spectrum efficacy and safety profile make it preferred in ischemic VT.

Reference: Katzung Basic and Clinical Pharmacology, 15th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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