Q2. Correct Answer: C
Rationale
Carvedilol is a nonselective beta-blocker with vasodilating properties that is used to decrease portal pressure and prevent first variceal hemorrhage. It has more robust effect on the reduction of portal pressure than nadolol or propranolol. A safe and effective dose is 12.5 mg/day. Doses higher than 12.5 mg a day are associated with increased side effects and hypotension in patients with impaired liver function caused alpha 1 antagonist action and excessive first pass metabolism.
References
1. Tripathi D, Ferguson JW, Kochar N, et al. Randomized controlled trial of carvedilol versus variceal band ligation for the prevention of the first variceal bleed. Hepatology. 2009 Sep;50(3):825-33.
2. Carvedilol (coreg) package insert Philadelphia. SmithKline Beecham Pharmaceuticals. May 1997.
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