After starting a beta-blocker, which adverse effects should you monitor?

After starting a beta-blocker, which adverse effects should you monitor?

• A. Rash
• B. Increased appetite
• C. Bradycardia, hypotension, fatigue; potential bronchospasm in asthma/COPD for nonselective agents
• D. Hypertension

Answer: (C)

Beta-blockers slow the heart and lower blood pressure, and they can reduce energy and exercise tolerance. The adverse effects you actively watch for are bradycardia (a heart rate that's too slow), hypotension (low blood pressure), and fatigue from decreased cardiac output. Because nonselective beta-blockers block beta-2 receptors in the lungs, they can provoke bronchospasm, especially in people with asthma or COPD, so monitor for wheezing, shortness of breath, or increased work of breathing. Rash is not a primary expected adverse effect of beta-blockers, and increased appetite is not typical for these drugs. Hypertension is also unlikely, since beta-blockers typically lower blood pressure rather than raise it. If a nonselective agent is used in a patient with lung disease, heightened vigilance for respiratory symptoms is crucial, and a cardioselective beta-blocker may be chosen when appropriate. Regularly check pulse and blood pressure, and assess breathing status after starting therapy.

Beta-blockers slow the heart and lower blood pressure, and they can reduce energy and exercise tolerance. The adverse effects you actively watch for are bradycardia (a heart rate that's too slow), hypotension (low blood pressure), and fatigue from decreased cardiac output. Because nonselective beta-blockers block beta-2 receptors in the lungs, they can provoke bronchospasm, especially in people with asthma or COPD, so monitor for wheezing, shortness of breath, or increased work of breathing.

Rash is not a primary expected adverse effect of beta-blockers, and increased appetite is not typical for these drugs. Hypertension is also unlikely, since beta-blockers typically lower blood pressure rather than raise it. If a nonselective agent is used in a patient with lung disease, heightened vigilance for respiratory symptoms is crucial, and a cardioselective beta-blocker may be chosen when appropriate. Regularly check pulse and blood pressure, and assess breathing status after starting therapy.