NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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Which opioid is known for causing life-threatening QT prolongation and serious arrhythmias according to its BBW?

Hydromorphone
Methadone
Fentanyl
Meperidine

The correct answer is: Methadone

Methadone is the correct answer because it is known for causing life-threatening QT prolongation and serious arrhythmias according to its Black Box Warning (BBW). Methadone has the potential to prolong the QT interval on an electrocardiogram (ECG), which can lead to a dangerous arrhythmia known as Torsades de Pointes. This risk is especially significant at higher doses or in individuals with certain risk factors. It is important for healthcare providers to monitor patients taking methadone for any signs of cardiac abnormalities to prevent potentially fatal complications. Among the other options: A. Hydromorphone is a potent opioid which does not have a BBW for causing QT prolongation. C. Fentanyl is a strong opioid analgesic, but it is not typically associated with significant QT prolongation or arrhythmias according to its BBW. D. Meperidine (Demerol) is known to have a toxic metabolite (normeperidine) which can accumulate in the body, especially in patients with renal impairment, but it does not specifically have a BBW for causing life-threatening QT prolongation and serious arrhythmias.