A 57-year-old man with NYHA class III heart failure is currently treated with furosemide and ramipril.. Bisoprolol

A 57-year-old man with NYHA class III heart failure is currently treated with furosemide and ramipril.

What is the most suitable beta-blocker to add to improve his long-term prognosis?
  • A. A Acebutolol
  • B. A Labetalol
  • C. A Bisoprolol***
  • D. A Sotalol
  • E. A Esmolol.

The most suitable beta-blocker to add to the patient's treatment regimen is C. Bisoprolol.

Bisoprolol is a selective beta-1 blocker that has been extensively studied and proven to improve long-term prognosis in patients with heart failure. It helps to reduce heart rate, blood pressure, and myocardial workload, leading to improved symptoms and reduced mortality.

Here's a brief comparison of the other options:

  • Acebutolol: While it has some beta-blocking properties, it also has alpha-1 blocking effects, which can lead to hypotension and dizziness, especially in patients with heart failure.
  • Labetalol: Similar to acebutolol, labetalol has both beta-blocking and alpha-blocking properties. It can be useful in hypertensive emergencies but is generally not the first-line choice for chronic heart failure.
  • Sotalol: This drug has both beta-blocking and potassium channel-blocking properties. It is primarily used for arrhythmias and is not typically recommended for heart failure.
  • Esmolol: This is a short-acting beta-blocker used primarily for acute conditions, such as rapid heart rate. It is not suitable for long-term treatment of heart failure.
Therefore, based on its efficacy and safety profile, bisoprolol is the most appropriate beta-blocker for this patient. However, it is important to note that the choice of beta-blocker should be individualized and based on the patient's specific clinical condition and other medications they are taking. It's always best to consult with a healthcare professional for personalized advice.
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