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Pharmacology — UKMLA MCQ

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HardPharmacologyUKMLAMRCGP AKTMRCP Part 1PSA

A patient with stable angina and asthma needs an additional anti-anginal medicine. Resting heart rate is 54 beats/min and blood pressure is 104/62 mmHg. Which factor most limits use of a beta blocker?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Asthma with clinically important resting bradycardia

The best answer is “Asthma with clinically important resting bradycardia”. Beta blockers can worsen bronchospasm and further slow an already bradycardic patient. Anti-anginal selection should therefore consider a non-rate-limiting alternative and specialist review rather than relying on receptor terminology alone. Stable coronary disease and nitrate rescue are indications for treatment planning, while normal EF and absence of diabetes do not create the principal contraindication.

Reference: NICE CG126: Stable angina — management: https://www.nice.org.uk/guidance/cg126/chapter/Recommendations