Beta Blockers USMLE Step 1 Practice Question
A 68-year-old man with hypertension and angina presents with dizziness and fatigue. Vital signs show BP 92/58 mmHg, HR 48 bpm, RR 14/min, temp 37°C, SpO2 98% on room air. He reports taking metoprolol 100 mg daily for 2 years. Electrocardiogram reveals normal sinus rhythm without conduction delays. He denies syncope. Which of the following best explains how beta-blockers' decreased blood solubility affects drug distribution and clinical onset of action?
Answer choices
- AHepatic metabolism becomes the dominant determinant of recovery
- BPotency always increases as blood solubility decreases
- CThe minimum alveolar concentration necessarily increases with blood solubility
- DMore drug is retained in blood, delaying equilibration with the brain
- EThe alveolar partial pressure rises quickly, accelerating inductionCorrect answer
- FLipophilic drugs accumulate in adipose tissue, causing prolonged elimination half-lives and sustained clinical effects
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