Family Nurse Practitioner Exam

Which antihypertensive medication should be avoided in patients with emphysema?

1. Calcium channel blockers

2. Angiotensin-converting enzyme (ACE) inhibitors

3. Beta-blockers

4. Diuretics

The correct answer is: Beta-blockers

The rationale for avoiding beta-blockers in patients with emphysema primarily revolves around the potential respiratory effects these medications can have. Beta-blockers, especially non-selective ones, can block beta-2 adrenergic receptors in the lungs. This can lead to bronchoconstriction, which is particularly concerning in patients with obstructive airway diseases such as emphysema. While some beta-blockers are cardioselective and have less impact on the lungs, the general caution against beta-blockers in respiratory conditions remains important, particularly in patients with a history of reactive airway disease or severe airflow limitation. When considering patients with emphysema, it's crucial to prioritize medications that do not exacerbate breathing problems. Other antihypertensive options, like calcium channel blockers, ACE inhibitors, and diuretics, do not share this significant risk of inducing bronchoconstriction. Therefore, beta-blockers are best avoided in this population to reduce the risk of respiratory complications.