Hypertensive crisis in prazosin-treated pheochromocytoma.
The selective alpha1-adrenergic antagonist prazosin has recently been recommended for the preoperative management of pheochromocytoma, but we have observed a hypertensive crisis in a patient with such a tumor, despite prazosin therapy. Her blood pressure was easily controlled with small doses of phenoxybenzamine, suggesting that less selective alpha-adrenergic blockade might be advantageous in this situation. The involvement of alpha 2-adrenoreceptors in pressor responses and a lack of evidence for presynaptic alpha 2 control of peripheral sympathetic tone in man suggest that selective alpha 1-blockade is not the optimal treatment of hypertension due to high levels of circulating catecholamines.
D000310:Adrenal Gland Neoplasms / Q000601:surgery*; D002395:Catecholamines / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008875:Middle Aged; D010643:Phenoxybenzamine / Q000627:therapeutic use; D010673:Pheochromocytoma / Q000601:surgery*; D011224:Prazosin / Q000008:administration & dosage*; D011292:Premedication; D011799:Quinazolines / Q000008:administration & dosage*
D002395:Catecholamines; D011799:Quinazolines; D010643:Phenoxybenzamine; D011224:Prazosin