This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: C.V.S, Subject name: Pharmacology
[{'content': 'Which one of the following drugs is associated with the development of a lupus-like syndrome, especially in patients identified as "slow acetylators"? \nSelect and explain. \nA. Arniodarone, B. Clonidine, C. Nitroglycerin, D. Procainamide', 'role': 'user'}, {'content': 'Answer: D \nExplanation: Procainamide is metabolized by N-acetyltransferase (a phase II drug metabolism reaction) to form N-acetyl-procainamide (NAPA), which itself has antiarrhythmic activity. Patients who are classified as slow acetylators may develop SLE-like symptoms when treated with procainamide. Other drugs metabolized via N-acetyltransferase, including isoniazid and hydralazine, have also been associated with lupus-like symptoms in slow acetylators.', 'role': 'assistant'}]