All are true about starting of beta-blocker therapy in a patient with congestive heart failure except:

A. They should be started with optimum doses

B. They should be gradually increased over weeks

C. Special precautions should be taken in cases of NYHA class III and IV

D. Carvedilol and metoprolol are the preferred drugs.

Correct Answer: They should be started with optimum doses

Description: Clinical use of β2 adrenergic receptor antagonists in heart failure These are now recommended for routine use in patients with an ejection fraction < 35% and NYHA class II or III symptoms in conjunction with ACE inhibitor or angiotensin-receptor antagonist, and diuretics. These should be initiated at very low doses, generally less than one-tenth of the final target dose. NYHA Class IIIB and IV patients should be approached with a high level of caution; and in recently decompensated heart failure, beta-blockers should not be used until the patients are stabilized for several days to weeks.

Category: Pharmacology

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