A 36 year-old man with a long history of depression visits her physician for persistent lower back pain. He takes amitriptyline once a day. His physician prescribes an opioid for his pain.

Which one of these opioids may predispose to prolonged QRS?

A-Fentanyl

B-Hydrocodone

C-Meperidine

D-Morphine

E-Propoxyphene




Answer:

Propoxyphene is the only one of the listed drugs that has sodium channel blocking activity which may predispose to QRS prolongations especially when used with tricyclic antidepressants such as amitriptyline.

The correct answer is E