Correct!
5. Transvenous pacemaker in the pulmonary artery
The catheter migrated into the pulmonary artery as seen in the fluoroscopic image. No complication occurred and the catheter was returned to the correct location using fluoroscopic guidance. There are no absolute complications of transvenous pacemakers with life threatening conditions such as recurrent TdP with hemodynamic instability (5). Relative contraindications are minimally symptomatic bradycardia, prosthetic tricuspid valves or active anticoagulation. Complications of transvenous pacemakers include lead dislodgement or disconnection, bleeding, infection, myocardial perforation, pulmonary embolism, pneumothorax and air embolism.
She was admitted to the medical intensive care unit, where she was able to be extubated and the pacemaker removed on hospital day four. She was neurologically intact and able to confirm that she had ingested loperamide.
Which medication is the most appropriate to prescribe for this patient after the acute toxicity has fully resolved? (Click on the correct answer to be directed to the seventh and final page)