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  #1  
Old 01-19-2012
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Default drug worsening hypertension

A patient presents with what was initially thought to be Stage 2 hypertension. The actual underlying cause—a pheochromocytoma—is not looked for nor detected in the initial work-up. An oral antihypertensive drug is prescribed. We soon find that the patient's blood pressure has risen to levels above pretreatment levels—so much so that we are worried about imminently dangerous effects from the drug-induced worsening of hypertension. Concomitant with the drug-induced rise of blood pressure the patient develops signs and symptoms of heart failure. Which of the following drugs was most likely administered?
A.
Captopril

B.
Hydrochlorothiazide

C.
Labetalol

D.
Losartan

E.
Propranolol

F.
Verapamil
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  #2  
Old 01-19-2012
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So pheochromocytoma is not diagnosed?

That means that it might stimulate a1 receptors if they are not blocked...

I'd say she is given a beta blocker... But which one I do not know, both Labetalol and Propranolol are non-selective...
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Old 01-19-2012
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I have no idea what this question is saying lol
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Old 01-19-2012
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I think c but it is strange question
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Old 01-19-2012
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Propranolol (because labetalol would also block a1... Just checked)
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hmm ... c ......
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Old 01-19-2012
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Ans E

Propranolol will promote the epi and norepi secreated by the tumor ,to cause unopposed alpha mediated vasoconstriction.
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yes propanol , lost my brains ...........
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Old 01-19-2012
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Its propanolol........leaves alpha receptors unopposed hence increase in HTN!!!!!!
In treatment of pheochromocytoma....... non selective alpha blockers ( phenoxybenzamine- non competitive inhibitor) is used followed by beta blockers.................always a combination therapy is followed....an IMPORTANT concept......
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