Hypothetical Case Study.
In a bustling private hospital in Kampala, a well-dressed man in his late 50s was rushed into the emergency unit. He was a well-known businessman, respected, wealthyβ¦ and having a hypertensive crisis. His BP? 190/120. π°
Enter a young medical intern β nervous, eager to impress. The supervising doctor was nowhere in sight. The intern scanned the chart, saw "hypertension", and quickly administered propranolol IV. π
Within seconds, the patient began gasping. Wheezing. His oxygen saturation plummeted.
He coded.
Despite resuscitation attempts, the man died on the spot. π’
What went wrong?
The patient had asthma β and propranolol is a non-selective beta blocker. Letβs break that down π§ͺ:
Beta-1 receptors are in the heart π β blocking them slows heart rate and lowers blood pressure.
Beta-2 receptors are in the lungs π« β they relax bronchial smooth muscle, keeping airways open.
β Propranolol blocks both Beta-1 and Beta-2.
So when you give it to a person with asthma, you can trigger severe bronchoconstriction β even a fatal asthma attack.
Before prescribing or administering a beta blocker, especially propranolol, ALWAYS:
β
Take a thorough medical history (especially respiratory conditions!)
β
Understand the difference between selective and non-selective beta blockers.
β
Consult your supervisor if unsure.
Propranolol = Non-selective beta blocker
MOA = Blocks Ξ²1 (heart) + Ξ²2 (lungs)
Risk in asthma = Bronchoconstriction β Hypoxia β Death
π‘ Safer alternatives in asthmatic patients include cardio-selective beta blockers like atenolol or metoprolol β but even these should be used cautiously.
We turned this case into a super fun & interactive quiz! π§ π₯
π― Take the quiz now at my Quiz Vault
π£οΈ Think youβd survive a clinical round? Let's find out.
Mistakes happen. But as future clinicians, our job is to learn from them β without shame, without fear β and become safer, smarter, and more prepared. This isnβt about guilt. Itβs about growth. πͺπΎ
See you in the next case study!
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