Cardiovascular drugs: clonidine withdrawal: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Pharmacology · Cardiovascular drugs: clonidine withdrawal

Sample item

A 54-year-old man on clonidine 0.2 mg three times a day ran out of tablets 2 days ago. He now has a pounding headache, sweating and palpitations with a blood pressure of 210/120 mmHg. What is the most appropriate step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Restart clonidine and taper slowly later

Clonidine stimulates central alpha-2 receptors and reduces sympathetic outflow. Abrupt stopping releases this restraint and causes a rebound surge of catecholamines. Restarting the drug treats it, and phentolamine or labetalol can be used for severe cases. Beta-blocker alone is hazardous because unopposed alpha stimulation can worsen hypertension.

Option by option

  • A. Give propranolol alone

    Beta-blockade alone leaves alpha vasoconstriction unopposed and can raise the blood pressure further.

  • B. Restart clonidine and taper slowly later (correct)

    Correct. Re-establishing alpha-2 agonism quells the rebound sympathetic surge.

  • C. Observe without treatment

    A pressure of 210/120 mmHg with symptoms from rebound needs treatment.

  • D. Give intravenous furosemide

    A diuretic does not address catecholamine excess in this volume-normal patient.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Pharmacology questions

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Restart clonidine and taper slowly later. Clonidine stimulates central alpha-2 receptors and reduces sympathetic outflow.

Why is "Give propranolol alone" not the answer?

Beta-blockade alone leaves alpha vasoconstriction unopposed and can raise the blood pressure further.

Why is "Observe without treatment" not the answer?

A pressure of 210/120 mmHg with symptoms from rebound needs treatment.

Why is "Give intravenous furosemide" not the answer?

A diuretic does not address catecholamine excess in this volume-normal patient.

What concept does this question test?

It tests Cardiovascular drugs: clonidine withdrawal in Pharmacology. Abrupt stopping releases this restraint and causes a rebound surge of catecholamines. Restarting the drug treats it, and phentolamine or labetalol can be used for severe cases. Beta-blocker alone is hazardous because unopposed alpha stimulation can worsen hypertension.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiovascular drugs: clonidine withdrawal?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.