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Pharmacology General a865b76c

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.
High-Yield Explanation
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.

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