Why is metoclopramide contraindicated in pheochromocytoma?
Metoclopramide is contraindicated in patients with pheochromocytoma because the drug may cause a hypertensive crisis, probably due to release of catecholamines from the tumor. Such hypertensive crises may be controlled by phentolamine.
How are pheochromocytomas diagnosed?
A pheochromocytoma is a catecholamine-secreting tumor of chromaffin cells typically located in the adrenals. It causes persistent or paroxysmal hypertension. Diagnosis is by measuring catecholamine products in blood or urine. Imaging tests, especially CT or MRI, help localize tumors.
Which is the most common surgical treatment option for a person with pheochromocytoma?
Surgical resection of the tumor is the treatment of choice for pheochromocytoma and usually results in cure of the hypertension. Careful preoperative management is required to control blood pressure, correct fluid volume, and prevent intraoperative hypertensive crises.
Which treatment is given to a patient with pheochromocytoma to control high BP before surgery?
Thus, its use in the preoperative treatment of patients with pheochromocytoma is controversial. During surgery, intravenous phentolamine, a rapid-acting alpha-adrenergic antagonist, is used to control blood pressure. Rapid-acting intravenous beta blockers, such as esmolol, are also used to normalize blood pressure.
Why is metoclopramide contraindicated in Parkinson’s disease?
Metoclopramide and prochlorperazine should be avoided as they are dopamine antagonists and make parkinsonism worse. If an antiemetic is required, domperidone 10-20 mg three times daily is the drug of choice as it is a dopamine antagonist which does not cross the blood-brain barrier.
Why is dopamine contraindicated in pheochromocytoma?
Alpha-blocker treatment is contraindicated for dopamine-secreting pheochromocytomas because case reports have shown it can lead to cardiovascular collapse and hypotensive crisis.
What are 4 possible treatments for pheochromocytoma?
The primary treatment for a pheochromocytoma is surgery to remove the tumor….Cancer treatments
- MIBG .
- Peptide receptor radionuclide therapy (PRRT).
- Chemotherapy.
- Radiation therapy.
- Targeted cancer therapies.
Which medication is contraindicated in a patient receiving selegiline for Parkinson’s disease?
If the patient is taking selegiline or rasagiline, other medications must also be avoided, for example, meperidine, traMADol, methadone, mirtazapine, St. John’s Wort, cyclobenzaprine, dextromethorphan, pseudoephedrine, phenylephrine, and ePHEDrine.
What medications should be avoided with pheochromocytoma?
Agents known to provoke a pheochromocytoma paroxysm (eg, beta-adrenergic blocker in absence of alpha-adrenergic blockade, glucagon, histamine, metoclopramide, high-dose corticosteroids) should be avoided.
What drugs are contraindicated in pheochromocytoma?
Drugs that increase sympathetic tone such as ketamine, ephedrine, pancuronium, metoclopramide should not be used in patients with pheochromocytoma [22]. Histamine provoking drugs such as morphine and atracurium should also be avoided.