A 54-year-old man with emphysema presents to his physician with a blood pressure of 157/101 mmHg. Over the next several months the physician prescribes angiotensin conveing enzyme inhibitors, diuretics, and calcium channel blockers, but the patient has to discontinue each agent because of undesirable side effects. The physician then decides to prescribe a beta antagonist. Which of the following would be most appropriate for this paicular patient?
Patients with nonallergic bronchospastic conditions, such as emphysema and chronic bronchitis, are generally not prescribed beta-receptor blocking agents since these agents can cause bronchoconstriction by blocking beta-2 receptors. However, relatively low doses of selective beta-1 receptor antagonists, such as metoprolol and atenolol, are relatively well tolerated in patients with emphysema. As a precautionary measure, emphysema patients receiving beta-1-selective blocking agents should use a bronchodilator with beta-2-stimulating activity. All the other answer choices are non selective beta receptor blocking agents and should not be used in the treatment of hypeension in patients with nonallergic bronchospasm since they are likely to exacerbate the signs and symptoms of the condition.
Metoprolol
Nadolol
Propranolol
Sotalol