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Toxicology – Drugs Causing Hypertension
Amphetamines
Amphetamines enhance the release of catecholamines, producing significant increases in blood pressure and heart rate.
Caffeine
Caffeine stimulates adrenergic activity, causing hypertension and tachycardia. In large overdoses, it may paradoxically result in hypotension and cardiovascular collapse.
Cocaine
Cocaine increases synaptic concentrations of serotonin, dopamine, and norepinephrine by blocking their reuptake, resulting in elevated blood pressure and heart rate.
Anticholinergics
Anticholinergic drugs suppress parasympathetic activity, leading to increased heart rate and elevated blood pressure.
Nicotine
Nicotine toxicity initially presents with hypertension and tachycardia, which may later progress to bradycardia and hypotension.
Sympathomimetics
These agents increase blood pressure and heart rate by promoting catecholamine release, decreasing their reuptake, or inhibiting their breakdown.
Thyroid Hormone
Excess thyroid hormone elevates basal metabolic rate and enhances responsiveness to catecholamines. In severe overdose, this may lead to cardiac dysrhythmias followed by hypotension and cardiovascular collapse.
Treatment
Benzodiazepines are the first-line treatment for hypertension due to sympathomimetic toxicity. Pure β-blockers should be avoided because they can cause unopposed α-adrenergic stimulation and worsen hypertension. Agents such as labetalol are preferred due to their combined α- and β-blocking effects.
Amphetamines
Amphetamines enhance the release of catecholamines, producing significant increases in blood pressure and heart rate.
Caffeine
Caffeine stimulates adrenergic activity, causing hypertension and tachycardia. In large overdoses, it may paradoxically result in hypotension and cardiovascular collapse.
Cocaine
Cocaine increases synaptic concentrations of serotonin, dopamine, and norepinephrine by blocking their reuptake, resulting in elevated blood pressure and heart rate.
Anticholinergics
Anticholinergic drugs suppress parasympathetic activity, leading to increased heart rate and elevated blood pressure.
Nicotine
Nicotine toxicity initially presents with hypertension and tachycardia, which may later progress to bradycardia and hypotension.
Sympathomimetics
These agents increase blood pressure and heart rate by promoting catecholamine release, decreasing their reuptake, or inhibiting their breakdown.
Thyroid Hormone
Excess thyroid hormone elevates basal metabolic rate and enhances responsiveness to catecholamines. In severe overdose, this may lead to cardiac dysrhythmias followed by hypotension and cardiovascular collapse.
Treatment
Benzodiazepines are the first-line treatment for hypertension due to sympathomimetic toxicity. Pure β-blockers should be avoided because they can cause unopposed α-adrenergic stimulation and worsen hypertension. Agents such as labetalol are preferred due to their combined α- and β-blocking effects.
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