RT Book, Section
A1 Zastrow, Mark von
A2 Katzung, Bertram G.
SR Print(0)
ID 1148432742
T1 Drug Receptors & Pharmacodynamics
T2 Basic & Clinical Pharmacology, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9781259641152
LK accessmedicine.mhmedical.com/content.aspx?aid=1148432742
RD 2024/04/19
AB CASE  STUDYA  51-year-old  man  presents  to  the  emergency  department  due  to  acute  difficulty  breathing.  The  patient  is  afebrile  and  normotensive  but  anxious,  tachycardic,  and  markedly  tachypneic.  Auscultation  of  the  chest  reveals  diffuse  wheezes.  The  physician  provisionally  makes  the  diagnosis  of  bronchial  asthma  and  administers  epinephrine  by  intramuscular  injection,  improving  the  patient’s  breathing  over  several  minutes.  A  normal  chest  X-ray  is  subsequently  obtained,  and  the  medical  history  is  remarkable  only  for  mild  hypertension  that  is  being  treated  with  propranolol.  The  physician  instructs  the  patient  to  discontinue  use  of  propranolol,  and  changes  the  patient’s  antihypertensive  medication  to  verapamil.  Why  is  the  physician  correct  to  discontinue  propranolol?  Why  is  verapamil  a  better  choice  for  managing  hypertension  in  this  patient?  What  alternative  treatment  change  might  the  physician  consider?