Psychiatric Drugs and Medications Q 19

---

Adrenergic blockers are contraindicated in:

  

     A. Hypertension

     B. Pheochromocytoma

     C. Migraines

     D. Obstructive airway disease

    

    

Correct Answer: D. Obstructive airway disease

---

Adrenergic blockers tend to cause bronchoconstriction, so are therefore contraindicated in obstructive pulmonary disease. Traditionally, beta-blockers have been contraindicated in asthmatic patients. However, recommendations have aligned for allowing cardio-selective beta-blockers, also known as beta-1 selective, in asthmatics but not non-selective beta-blockers. Less commonly, bronchospasm presents in patients on beta-blockers. Asthmatic patients are at a higher risk.

---

Option A: Patients who have either acute or chronic bradycardia and/or hypotension have relatively contraindication to beta-blocker usage. The patient’s heart rate and blood pressure require monitoring while using beta-blockers. Bradycardia and hypotension are two adverse effects that may commonly occur.

Option B: Beta receptors are found all over the body and induce a broad range of physiologic effects. The blockade of these receptors with beta-blocker medications can lead to many adverse effects. The catecholamines, epinephrine, and norepinephrine bind to B1 receptors and increase cardiac automaticity as well as conduction velocity. B1 receptors also induce renin release, and this leads to an increase in blood pressure. In contrast, binding to B2 receptors causes relaxation of the smooth muscles along with increased metabolic effects such as glycogenolysis.

Option C: Beta-blockers are indicated and have FDA approval for the treatment of tachycardia, hypertension, myocardial infarction, congestive heart failure, cardiac arrhythmias, coronary artery disease, hyperthyroidism, essential tremor, aortic dissection, portal hypertension, glaucoma, migraine prophylaxis, and other conditions.

---