All of the following are true about staing betablocker therapy in cases of CHF, Except
Answer is A (They should be initiated at the effective doses) Beta blocker should be initiated at lower than effective doses in CHF Beta blockers should be initiated at lower than effective doses in CHF and be 'Beta blockers should be initiated at low doses followed by gradual increments in the dose if lower doses have been well tolerated. The dose of beta blockers should be increased until the doses used are similar to those that have been repoed effective in clinical trials. The titration of beta blockers should proceed no more rapidly than at 2 week intervals because the initiation and / or increased dosing of these agents may lead to worsening fluid retention' -- Harrison's 17th/1450 Special precaution should be taken in NYHA class III & IV 'Although data suggests that patients with NYHA class IHB and IV CHF may tolerate beta blockers and benefit from their use, this group of patients should be approached with considerable caution' --Goodman & Gillman's Manual of Pharmacology (2007)/570 Carvedilol and Metoprolol are the preferred beta blockers in CHF `Non selective third generation beta blockers (Bucindolol, Carvedilol) as well a the Beta-I selective agent (Metoprolol) are generally well tolerated by patients with CHF'. -'Current Diagnosis & Treatment in Cardiology' 3,1/217
They should be initiated at the effective doses
They should be gradually increased over weeks
Special precautions should be taken in NYHA class III & IV
Carvedilol and Metoprolol are the preferred drugs