A 50-year-old woman abruptly stops her antihypertensive medication. Two days later she develops BP 200/125 mmHg, sweating, tachycardia, and headache. Her medication was most likely which of the following?
- A Amlodipine
- B Clonidine ✓
- C Losartan
- D Chlorthalidone
Correct answer: B. Clonidine
Explanation
Clonidine is a central alpha-2 agonist that suppresses sympathetic outflow from the brainstem. Abrupt withdrawal causes rebound hypertension, tachycardia, diaphoresis, and anxiety due to loss of this suppression and overshoot catecholamine release. Treatment is reinstitution of clonidine or use of alpha and beta blockers. Calcium channel blockers, ARBs, and thiazides do not produce this classic rebound sympathetic surge on discontinuation.
Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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