A patient with pheochromocytoma is being prepared for surgical removal of the tumor. Which of the following drugs would be MOST appropriate to control the hypertensive crisis before and during surgery?

• A Propranolol alone
• B Phentolamine followed by propranolol if needed ✓
• C Prazosin alone
• D Esmolol alone

Explanation

Phentolamine, a non-selective alpha blocker, is the drug of choice for hypertensive crises in pheochromocytoma. A beta-blocker like propranolol may be added subsequently if tachycardia persists, but must never be given first — blocking beta-2 vasodilation with alpha stimulation unopposed would dramatically worsen hypertension. Prazosin is used for long-term preoperative preparation, not acute crises.

Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.