title: Propranolol-induced hypertension in treatment of cocaine intoxication.
abstract: The case of a patient with apparent cocaine toxicity and drug-mediated hypertension and tachycardia is presented. IV propranolol was used as the initial treatment for his hyperadrenergic state, resulting in a decrease in heart rate but a paroxsymal increase in blood pressure. The patient required nitroprusside for control of elevated blood pressure. A mechanism of unopposed alpha stimulation as a result of beta-2 receptor blockade is proposed, and a cautious approach to the use of propranolol in these patients is suggested.
mesh_terms: D003042:Cocaine / Q000009:adverse effects*; D004630:Emergencies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009599:Nitroprusside / Q000627:therapeutic use; D011041:Poisoning / Q000188:drug therapy / Q000209:etiology*; D011433:Propranolol / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D009599:Nitroprusside; D011433:Propranolol; D003042:Cocaine