A 49-year-old male is diagnosed with hypertension. He is a known asthmatic. His creatinine and potassium are both slightly elevated. Which of the following drugs would be appropriate in his case?
## **Core Concept**
The question requires selecting an antihypertensive drug suitable for a patient with asthma and slightly elevated creatinine and potassium levels. The ideal drug should not exacerbate asthma, should be cautious in renal impairment, and should not significantly increase potassium levels.
## **Why the Correct Answer is Right**
The correct answer, **C. Amlodipine**, is a calcium channel blocker (CCB), specifically a dihydropyridine type. CCBs are known for their bronchodilatory effects, making them suitable for patients with asthma. They also have a neutral effect on potassium levels and are safe to use in patients with renal impairment, although dose adjustments might be necessary.
## **Why Each Wrong Option is Incorrect**
- **Option A:** Beta-blockers can exacerbate asthma by causing bronchoconstriction through non-selective beta-2 adrenergic receptor blockade. They are generally contraindicated in asthma.
- **Option B:** ACE inhibitors can increase potassium levels (hyperkalemia) and are used with caution in renal impairment. They are not the first choice in this scenario.
- **Option D:** Spironolactone is a potassium-sparing diuretic. Given the patient's slightly elevated potassium levels, this drug could worsen hyperkalemia.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that calcium channel blockers like **Amlodipine** are often considered safe in patients with asthma and are effective in lowering blood pressure without adversely affecting potassium levels or lung function.
## **Correct Answer:** . Amlodipine