MEDizzy - A 66-year-old woman with a long history of heavy smoking

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Drugs acting on autonomic nervous system

A 66-year-old woman with a long history of heavy smoking presents to her doctor with complaints of shortness of breath and chronic coughing that has been present for about 2 years and has been worsening in frequency. The doctor decides to prescribe a bronchodilator agent that has minimal cardiac side effects, since the patient also has an extensive cardiac history. Which medication did the doctor likely prescribe?

ExplanationIpratropium bromide is used extensively for chronic obstructive pulmonary disease (COPD), which is the most likely diagnosis in this case. It acts by antagonizing muscarinic receptors in bronchial smooth muscle, thereby causing bronchodilation. Albuterol is also used for the treatment of COPD; however, it can cause adverse cardiac effects such as tachycardia and is not recommended in this case. Prazosin is an α-blocker used for benign prostatic hypertrophy (BPH). Atenolol is a β-blocker used for hypertension. Pseudoephedrine is an α-agonist used for nasal congestion.