Which beta-blocker is preferred in a patient with COPD who requires treatment for angina because it has the highest cardioselectivity (beta-1 selectivity) among the following options?
- A Nebivolol ✓
- B Propranolol
- C Atenolol
- D Carvedilol
Correct answer: A. Nebivolol
Explanation
Nebivolol has the highest beta-1 selectivity among marketed beta-blockers and additionally releases nitric oxide contributing to vasodilation; it is preferred in COPD when a beta-blocker is necessary. Propranolol is non-selective (blocks beta-1 and beta-2), risking bronchoconstriction. Atenolol is cardioselective but less so than nebivolol. Carvedilol blocks alpha-1, beta-1 and beta-2 — making it less suitable in COPD.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.