All are true about staing of Beta blocker therapy in a patient with congestive hea failure except
Ref-Goodman and Gillman 11/e p1336 Clinical use of Beta adrenergic receptor antagonist in hea failure These are now recommended for routine use in class Il or Ill symptoms in conjunction with ACE inhibitoror angiotensin-receptor antagonist, and diuretics These should be initiated at very low doses, generally less than one tenth of the final target dose NYHA Class IIIB and IV patients should be approached with a high level of caution; and in recently decompensated hea failure, beta-blockers should not be used until the patients are stabilizedfor several days to weeks.
That should be staed with optimum doses
They should be gradually increased over weeks
Special precautions should be taken in cases of NYHA class III and IV
Carvedilol and metoprolol are the preferred drugs
Cardiovascular system