A 43-year-old woman presents with episodic headaches, diaphoresis, and palpitations. During an acute episode, vital signs show BP 198/112 mm Hg, HR 118/min, RR 20/min, and temp 37.2°C. Plasma metanephrines are markedly elevated at 850 pg/mL (normal <90). CT imaging reveals a 3-cm left adrenal mass. She denies chest pain. She takes no current medications. Which drug should be initiated preoperatively to prevent hypertensive crises during surgical resection?
- A)Hydrochlorothiazide
- B)Metoprolol
- C)Digoxin
- D)PhenoxybenzamineGABARITO
- E)Propranolol
Explicação
Phenoxybenzamine is an irreversible nonselective alpha blocker used before resection of pheochromocytoma to control catecholamine mediated vasoconstriction. Alpha blockade should precede any beta blockade to avoid unopposed alpha stimulation. Ver explicação completa e trilha adaptativa →