FPGEE for National Association of Boards of Pharmacy (NABP) Practice Exam

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Which of the following conditions is propranolol contraindicated in?

Hypertension
Heart failure
Asthma
Hypotension

The correct answer is: Asthma

Propranolol, a non-selective beta-blocker, is contraindicated in asthma because it can provoke bronchospasm. This occurs due to the blockade of beta-2 adrenergic receptors found in the bronchial tissues, which are responsible for bronchodilation. In individuals with asthma, bronchospasm can lead to significant respiratory distress and exacerbation of their condition. In contrast, propranolol may be used cautiously in hypertension and is sometimes prescribed for heart failure under careful medical supervision. While hypotension could be another concern, it generally refers to low blood pressure, and propranolol would not typically be prescribed in that scenario as it can further reduce blood pressure. However, the most direct contraindication is in patients with asthma due to the potential for severe bronchoconstriction.