CEA Nursing Practice Exam

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Which beta blocker is considered the safest for managing CAD in a patient with severe COPD?

Carvedilol (Coreg)
Propranolol (Inderal)
Labetalol (Trandate)
Metoprolol (Lopressor)

The correct answer is: Metoprolol (Lopressor)

Metoprolol is considered the safest beta blocker for managing coronary artery disease (CAD) in a patient with severe chronic obstructive pulmonary disease (COPD) due to its selective action on beta-1 adrenergic receptors. This selectivity minimizes the risk of bronchoconstriction, which can be a significant concern when using beta blockers in individuals with lung conditions like COPD. Unlike non-selective beta blockers, such as propranolol and labetalol, which can block both beta-1 and beta-2 receptors, metoprolol primarily affects the heart. This means it can lower heart rate and reduce myocardial oxygen demand without causing the airway constriction that can exacerbate respiratory issues in COPD patients. Carvedilol, while also a beta blocker, has additional alpha-1 blocking properties that can lead to vasodilation, but it is still non-selective and may pose more risk in patients with significant respiratory issues. Thus, metoprolol is preferred in this context for managing CAD while considering respiratory safety for patients with COPD.