Psychopharmacology: hypotension caused by chlorpromazine: practice question

A Psychiatry 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.

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Psychiatry · Psychopharmacology: hypotension caused by chlorpromazine

Sample item

A patient on chlorpromazine collapses with severe hypotension and needs a vasopressor. Which agent is appropriate, and which should be avoided?

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

The answer and the reasoning

D. Noradrenaline; avoid adrenaline

Chlorpromazine blocks alpha-1 receptors, so adrenaline acts mainly on unopposed beta-2 receptors, causing vasodilation and worse hypotension (adrenaline reversal). A pure alpha agonist such as noradrenaline or phenylephrine is used.

Option by option

  • A. Adrenaline; avoid noradrenaline

    Adrenaline would produce adrenaline reversal in the presence of alpha blockade.

  • B. Salbutamol; avoid adrenaline

    Salbutamol is a beta-2 agonist and does not raise blood pressure.

  • C. Isoprenaline; avoid noradrenaline

    Isoprenaline is a pure beta agonist and would vasodilate further.

  • D. Noradrenaline; avoid adrenaline (correct)

    Correct. Alpha stimulation restores tone, while adrenaline would worsen vasodilation.

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.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Noradrenaline; avoid adrenaline. Chlorpromazine blocks alpha-1 receptors, so adrenaline acts mainly on unopposed beta-2 receptors, causing vasodilation and worse hypotension (adrenaline reversal).

Why is "Adrenaline; avoid noradrenaline" not the answer?

Adrenaline would produce adrenaline reversal in the presence of alpha blockade.

Why is "Salbutamol; avoid adrenaline" not the answer?

Salbutamol is a beta-2 agonist and does not raise blood pressure.

Why is "Isoprenaline; avoid noradrenaline" not the answer?

Isoprenaline is a pure beta agonist and would vasodilate further.

What concept does this question test?

It tests Psychopharmacology: hypotension caused by chlorpromazine in Psychiatry. A pure alpha agonist such as noradrenaline or phenylephrine is used.

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 Psychopharmacology: hypotension caused by chlorpromazine?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry 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.