A hypertensive patient with asthma presents with dry cough, wheezing, and a heart rate of 55 bpm. Which of the following drugs is the most likely cause? A - Metoprolol B - Lisinopril C- Amlodipine D - Hydrochlorothiazide
Quick Answer: The most likely cause is B - Lisinopril.
- Dry cough is a classic side effect of ACE inhibitors (like lisinopril), occurring in ~10-15% of patients due to bradykinin accumulation in the lungs.
- Wheezing can be triggered or worsened by this cough/bradykinin-mediated bronchoconstriction, especially in asthmatic patients.
- Heart rate of 55 bpm (borderline bradycardia) is a distractor - while metoprolol (a beta-blocker) causes bradycardia AND is contraindicated in asthma, the combination of dry cough + wheezing points squarely to an ACE inhibitor.
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