Autonomic nervous system: beta blockers with partial agonist activity: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Autonomic nervous system: beta blockers with partial agonist activity

Sample item

A hypertensive man with a resting heart rate of 52 per minute needs a beta blocker, and the prescriber wants one least likely to worsen resting bradycardia. Which drug is the best choice?

AAtenololBPindololCPropranololDMetoprolol

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Pindolol

Pindolol and acebutolol have intrinsic sympathomimetic activity, so they partly stimulate the beta receptor while blocking catecholamines. This reduces resting bradycardia and lipid disturbance compared with pure antagonists. They are less effective after myocardial infarction, where pure blockers are preferred.

Option by option

A. Atenolol
Atenolol is a pure beta-1 antagonist with a clear bradycardic effect.
B. Pindolol (correct)
Correct. Partial agonist activity keeps the resting heart rate from falling as far.
C. Propranolol
Propranolol is a pure non-selective antagonist and lowers the resting heart rate.
D. Metoprolol
Metoprolol is a pure beta-1 antagonist and also slows the resting rate.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Pindolol. Pindolol and acebutolol have intrinsic sympathomimetic activity, so they partly stimulate the beta receptor while blocking catecholamines.

Why is "Atenolol" not the answer?

Atenolol is a pure beta-1 antagonist with a clear bradycardic effect.

Why is "Propranolol" not the answer?

Propranolol is a pure non-selective antagonist and lowers the resting heart rate.

Why is "Metoprolol" not the answer?

Metoprolol is a pure beta-1 antagonist and also slows the resting rate.

What concept does this question test?

It tests Autonomic nervous system: beta blockers with partial agonist activity in Pharmacology. This reduces resting bradycardia and lipid disturbance compared with pure antagonists. They are less effective after myocardial infarction, where pure blockers are preferred.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Autonomic nervous system: beta blockers with partial agonist activity?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.