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Which beta blocker is often used in patients with both COPD and CAD due to its safer profile?

  1. Propranolol

  2. Carvedilol

  3. Metoprolol

  4. Esmolol

The correct answer is: Metoprolol

Metoprolol is frequently utilized in patients who have both Chronic Obstructive Pulmonary Disease (COPD) and Coronary Artery Disease (CAD) primarily due to its selective action on beta-1 adrenergic receptors, which minimizes the risk of bronchoconstriction. Unlike non-selective beta blockers, such as propranolol, metoprolol does not significantly block beta-2 receptors in the lungs, making it a more suitable option for individuals with respiratory conditions. The cardioselectivity of metoprolol allows for effective management of heart rate and blood pressure without exacerbating respiratory symptoms, making it safer for use in patients with COPD. Additionally, metoprolol is effective in decreasing mortality in patients with heart failure and is commonly prescribed for managing hypertension and angina. Other options, such as carvedilol and esmolol, while they have their benefits, are either non-selective or have a shorter duration of action. Carvedilol can block both beta-1 and beta-2 adrenergic receptors and may not be the best choice for patients with COPD due to its potential to cause bronchoconstriction. Esmolol, while selective, is typically used in acute settings due to its very short