A 65-year-old man with hypertension is found to have bilateral renal artery stenosis on Doppler. Which antihypertensive is absolutely contraindicated in this setting?
- A Amlodipine
- B Lisinopril ✓
- C Hydrochlorothiazide
- D Metoprolol
Correct answer: B. Lisinopril
Explanation
ACE inhibitors are contraindicated in bilateral renal artery stenosis because they dilate the efferent arteriole, causing a sharp fall in glomerular filtration pressure and acute renal failure. Calcium channel blockers, thiazides, and beta-blockers do not share this risk and are safer alternatives.
Reference: Katzung's Basic & Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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