Question

An adult male comes to the clinic with complaints that he is experiencing increased difficulty breathing over the past few days. He has a history of asthma and coronary artery disease. He was recently diagnosed with hypertension. Examination reveals no jugular vein distention and no productive cough. Breath sounds are present, but expiratory wheezes are noted bilaterally, and he denies any chest pain. His vital signs are pulse of 74 beats/min, respirations of 32 breaths/min, and BP of 160/100 mm Hg. His current medications are albuterol (Proventil) inhaler 2 puffs every 4 hours prn for wheezing, nitroglycerin transdermal patch, and propranolol (Inderal) 60 mg PO bid. What is the best treatment for this patient?

		Discontinue propranolol and begin verapamil (Calan) 80 mg PO tid qd.
		Begin theophylline (Theo-24; methylxanthine) 200 mg q12h PO.
		Discontinue propranolol (Inderal) and begin atenolol (Tenormin) 50 mg PO qd.
		Start beclomethasone (Beclovent) inhaler 2 puffs 3 to 4 times daily

Answer 1

1. The best treatment is-

A. Discontinue proponol and begin Verapramil 80 mg PO tid qd.

Explanation-

The proponol is a medicine of Non- selective Beta Blocker. This drug can block Beta receptor in in respiratory passage and irrates the airway if you has asthma. This cause the airway constrict, which leads to short ness of breath and wheezing.

But the Verapramil is a group of Calcium Channel Blocker. It does not cause any harm to asthma patient. So it is used in asthma.