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Side Effects of Alpha 1 Adrenergic Receptor Blockers 1

Side effects of alpha-1 adrenergic receptor blockers
pharmacology

Question

Vignette: A 42-year-old woman presents to the clinic with complaints of generalized weakness, fatigue and palpitations. She has a past medical history of hypertension and hyperthyroidism. She reports that she had been taking an antihypertensive medication regularly but recently stopped it due to a dry cough. Her blood pressure is 150/90 mm Hg and pulse rate is 110/min. The clinician decides to restart her on a different antihypertensive medication and prescribes a drug that selectively blocks the alpha-1 adrenergic receptors.

Question: Which of the following side effects is the patient most likely to experience from the newly prescribed antihypertensive medication?

Choices

A) Bronchospasm

B) Hyperkalemia

C) Orthostatic hypotension

D) Peptic ulcers

E) Tinnitus

Answer

C) Orthostatic hypotension

Explanation

The patient was previously on an ACE inhibitor, which can cause a dry cough, and is now being started on an alpha-1 adrenergic receptor blocker for her hypertension. Alpha-1 adrenergic receptor blockers such as prazosin, terazosin, and doxazosin are often used in the management of hypertension. These drugs block the alpha-1 adrenergic receptors on the vascular smooth muscles, causing vasodilation and a decrease in peripheral vascular resistance, which helps lower blood pressure. However, one of the common side effects of these drugs is orthostatic hypotension due to the sudden decrease in systemic vascular resistance. This can cause symptoms such as dizziness and fainting, particularly when the patient stands up from a sitting or lying position.

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