Which adverse effect is often seen with nonselective beta-blockers?

• A. Hypertension
• B. Hyperglycemia
• C. Increased intraocular pressure
• D. Bronchoconstriction

Answer: (D)

Blocking both beta-1 and beta-2 receptors is the situation here. In the lungs, beta-2 receptors normally promote bronchodilation; when they’re blocked by nonselective beta-blockers, that relaxation is lost and bronchoconstriction can occur. This makes bronchospasm or wheezing particularly likely, especially in patients with asthma or COPD. That’s why bronchoconstriction is the adverse effect you’d expect with nonselective beta-blockers. Hypertension would typically improve with these drugs, not worsen; hyperglycemia isn’t the classic direct effect ( though beta-blockers can affect glucose handling and mask hypoglycemia); and increased intraocular pressure isn’t driven by systemic beta-blockade—in fact, beta-blockers are sometimes used to lower intraocular pressure in glaucoma.