Before surgical removal of a pheochromocytoma, which drug class is used to control hypertension due to catecholamine excess?

• A. Alpha-adrenergic blocker
• B. Beta-adrenergic blocker
• C. ACE inhibitor
• D. Diuretic

Answer: (A)

Pheochromocytoma causes hypertension by excess catecholamines stimulating alpha receptors on blood vessels, leading to vasoconstriction, and beta receptors, contributing to tachycardia. Before tumor removal, the goal is to blunt those catecholamine effects to prevent intraoperative hypertensive crises. Blocking alpha receptors lowers peripheral vascular resistance and BP, providing stability during surgery. Only after adequate alpha blockade is achieved is a beta blocker added if persistent tachycardia remains; giving a beta blocker first can leave alpha-mediated vasoconstriction unchecked, risking a dangerous blood pressure surge. ACE inhibitors or diuretics don’t address the primary vasoconstrictive mechanism and are not the principal preoperative control for catecholamine-induced hypertension. Therefore, alpha-adrenergic blockade is the best choice for preoperative blood pressure control.