Which medication should be avoided in patients with chronic obstructive pulmonary disease (COPD)?

In patients with chronic obstructive pulmonary disease (COPD), the use of beta-blockers should generally be approached with caution, particularly non-selective beta-blockers. While these medications can have beneficial cardiovascular effects, they may also exacerbate respiratory symptoms due to their action on beta-2 adrenergic receptors, which are involved in bronchodilation. This is particularly concerning for patients with COPD, where bronchodilation is a key component of their management.

Selective beta-blockers can be used if absolutely necessary and may be safer, but the potential for exacerbating bronchospasm makes it critical to weigh the risks and benefits. In contrast, short-acting bronchodilators, antibiotics, and oral corticosteroids are generally accepted in COPD management. Short-acting bronchodilators are essential for acute symptom relief, antibiotics may be indicated in cases of exacerbation due to infection, and oral corticosteroids are sometimes used for their anti-inflammatory effects during exacerbations.

Therefore, the key reason beta-blockers, especially non-selective ones, should be avoided in COPD patients is their potential to worsen airway obstruction and trigger respiratory distress.