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Medicine C.V.S 4f825679

A person has headache & profuse sweating. On examination his B.P is 200/120 mm Hg. Which of the following shoud not be used

A
Nifedipine
B
Sodium nitroprusside
C
Phenoxybenozamine
D
Methyldopa
High-Yield Explanation
Patients who respond to shoacting vasodilators at the time of cardiac catheterization (a fall in mean pulmonary aerial pressure >=10 mmHg and a final mean pressure <40 mmHg) should be treated with calcium channel blockers. Typically, these patients require high doses (e.g., nifedipine, 240 mg/d, or amlodipine, 20 mg/d). Patients may have dramatic reductions in pulmonary aery pressure and pulmonary vascular resistance associated with improved symptoms, regressionof RV hyperophy, and improved survival now documented to exceed 20 years. However, <20% of patients respond to calcium channel blockers in the long term. These drugs are not effective in patients who are not vasoreactive. ref:Harrison&;s principles of internal medicine,ed 18,pg no 2079

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