Family Nurse Practitioner Exam

Which detail is important to consider before prescribing beta-blockers for essential tremor?

1. Patient history of asthma

2. Presence of second- or third-degree heart block

3. Presence of hypertension

4. Recent use of anti-depressants

The correct answer is: Presence of second- or third-degree heart block

When considering the prescription of beta-blockers for essential tremor, the presence of second- or third-degree heart block is particularly important. Beta-blockers can have significant effects on heart rate and conduction, and prescribing them to a patient with these types of heart block could lead to serious complications, such as worsened bradycardia or complete heart block. These conditions already indicate an impaired conduction system within the heart, and adding a medication that further decreases heart rate may exacerbate the situation, potentially leading to syncope or other cardiovascular issues. While other factors like a history of asthma or the presence of hypertension are important to consider in a broader clinical context, they do not pose as immediate a risk in this specific scenario of prescribing beta-blockers for essential tremor. Beta-blockers can sometimes be used cautiously in asthmatic patients under certain conditions, although they may not be the first choice. In the case of a patient with hypertension, the consideration for using beta-blockers would be more related to their overall therapeutic benefits rather than an immediate contraindication. Recent use of anti-depressants typically does not have a direct contraindication with beta-blockers, though it is prudent to monitor for drug interactions.