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Hypertensive response to propranolol in a patient treated with methyldopa—a proposed mechanism
Author(s) -
Nies Alan S.,
Shand David G.
Publication year - 1973
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1002/cpt1973145823
Subject(s) - propranolol , norepinephrine , methyldopa , metabolite , medicine , pharmacology , alpha (finance) , anesthesia , blood pressure , surgery , dopamine , construct validity , patient satisfaction
A patient is presented who had a hypertensive response to intravenous propranolol after having been treated for several days with methyldopa. Experimental work in dogs demonstrated that the pressor activity of alpha‐methyl‐norepinephrine, a metabolite of methyldopa, is enhanced by propranolol. We postulate that, during stress, the patient released alpha‐methyl‐norepinephrine and that propranolol acted to potentiate the pressor activity of this metabolite, resulting in a hypertensive response.