Which class of medication is contraindicated in patients with COPD during a chemical stress test for causing bronchospasms?

In patients with Chronic Obstructive Pulmonary Disease (COPD), beta-blockers can be concerning due to their potential to cause bronchoconstriction. However, the selection of vasodilators as the contraindicated medication during a chemical stress test specifically relates to their physiologic effects.

Vasodilators, such as adenosine or regadenoson, can lead to significant cardiovascular effects, including potential bronchospasm due to their action on the bronchial vasculature and smooth muscle. In patients with existing airway hyperreactivity, like those with COPD, the use of such medications can exacerbate respiratory symptoms and induce bronchospastic episodes.

In contrast, calcium channel blockers are generally less likely to cause bronchospasm and may actually be used in some cases to treat patients with reactive airway disease, while diuretics do not directly impact bronchial smooth muscle function. Therefore, choosing vasodilators is appropriate in this scenario to prevent exacerbation of bronchospasm during a chemical stress test in patients with COPD.