A 60-year-old immigrant from Latin America was told she
had hypertension and should be taking antihypertensive
medication. She decides to take an herbal medication from
an online “holistic pharmacy.” One week after starting the
medication, she is found unconscious in her apartment. In
the emergency department, her blood pressure is 50/0 mm
Hg and heart rate is 40 bpm. Respirations are 20/min; pupils
are slightly constricted. Bowel sounds are present. Which
of the following would be the most effective cardiovascular
stimulant?
(A) Amphetamine
(B) Clonidine
(C) Isoproterenol
(D) Norepinephrine
(E) Tyramine
(D) Norepinephrine
Norepinephrine is a potent cardiovascular stimulant that acts on alpha and beta adrenergic receptors. It is commonly used in cases of severe hypotension to increase blood pressure and heart rate. In this case, the patient has severely low blood pressure and heart rate, so norepinephrine would be the most effective choice to help stabilize her cardiovascular system.