This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: AIIMS 2018, Subject name: Pharmacology
A hypeensive patient was on metoprolol treatment. Verapamil was added to the therapy of this patient. This can result in:- 
Select and explain. 
A. Atrial fibrillation, B. Bradycardia with AV block, C. Torsades de pointes, D. Tachycardia
B: Bradycardia with AV block
Answer: B: Bradycardia with AV block 
Explanation: Metoprolol (Cardioselective beta blocker) decrease hea rate and AV conduction. Verapamil and Diltiazem: CCB (calcium channel blocker): These also inhibits SA Node and AV Node, hence depress the hea. So, when verapamil (or Diltiazem) is combined with metoprolol, they both depress hea and lead to bradycardia with AV block. Other CCBs include dihydropyridines (like amlodipine etc). These dipines can be used with Metoprolol as they cause reflex tachycardia.