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Pharmacology · patient case question

Prazosin produces its antihypertensive effect by which mechanism, and which adverse effect follows?

Patient case: Antihypertensive Review & Gingival Enlargement

demo: 60-year-old male

chief: “My gums have been growing over my front teeth.”

history: Hypertension, benign prostatic hyperplasia, angina.

meds: Nifedipine, prazosin, terazosin, atenolol

findings: Generalized fibrotic enlargement of the interdental papillae, most marked in the anterior maxilla. Plaque index moderate. No bone loss on bitewings.

  1. Aldosterone antagonism, producing hyperkalemia
  2. Direct arteriolar dilation, producing lupus-like syndrome
  3. Beta-2 agonism, producing tremor and tachycardia
  4. Alpha-1 adrenergic receptor antagonism, producing dizziness, drowsiness, nasal congestion, and palpitations
Show answer and explanation

Correct answer: D. Alpha-1 adrenergic receptor antagonism, producing dizziness, drowsiness, nasal congestion, and palpitations

  • A. Aldosterone antagonism describes spironolactone.
  • B. A lupus-like syndrome is classically associated with hydralazine and procainamide.
  • C. Beta-2 agonism describes albuterol.
  • D. Correct. Alpha-1 blockade relaxes vascular smooth muscle and the bladder neck. First-dose orthostatic hypotension, dizziness, drowsiness, nasal congestion, and palpitations are typical — rise the patient slowly from the dental chair.

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