Which of the following medications requires close observation for bronchospasm in the client with chronic obstructive pulmonary disease or asthma?

Which of the following medications requires close observation for bronchospasm in the client with chronic obstructive pulmonary disease or asthma?
A . Verapamil (Isoptin)
B . Amrinone (Inocor)
C . Epinephrine (Adrenalin)
D . Propranolol (Inderal)

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Answer: D

Explanation:

(A) Verapamil has the respiratory side effect of nasal or chest congestion, dyspnea, shortness of breath (SOB), and wheezing.

(B) Amrinone has the effect of increased contractility and dilation of the vascular smooth muscle. It has no noted respiratory side effects.

(C) Epinephrine has the effect of bronchodilation through stimulation.

(D) Propranolol, esmolol, and labetalol are all -blocking agents, which can increase airway resistance and cause bronchospasms.