My Kaplan Notes are saying we give only alpha blockers such as phenoxybenzamine and phentolamin. But a question in USMLERx is also talking about the use of beta blockers? Can anybody enlighten me please ...
The main issue in pheochromocytoma is elevated level of catecholamines. These when they act on alpha receptors they cause vasoconstriction and so increased peripheral vascular resistance and thence systemic hypertension so it would be wise to give a non specific alpha blocker such as phentolamine or an alpha 1 receptor blocker such as prazocin.
But also remember that epinephrine also work on beta receptors, particularly Beta one receptors in the heart causing increased contractility contributing to the patient excited status. So it would be wise to block the beta effects also.
In clinical practice they usually give alpha blockers alone and then if no adequate control they add beta blockers.
But very importantly here, Never Give Beta Blockers Alone. Because if you do so you'll leave the alpha effects unopposed and so you'll worsen the hypertension.
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