Which drug should be avoided to treat hypotension in carcinoid disease due to release of vasoactive substances?

Which drug should be avoided to treat hypotension in carcinoid disease due to release of vasoactive substances?

• A. Epinephrine
• B. Octreotide
• C. Vasopressin
• D. Norepinephrine

Answer: (A)

In carcinoid disease, the tumor can release vasoactive substances such as serotonin, bradykinin, and histamine. Certain drugs can provoke the tumor to release these mediators, sparking or worsening a carcinoid crisis with profound hypotension and flushing. Epinephrine is a drug that can trigger further mediator release due to its broad adrenergic effects, which may worsen the crisis rather than stabilize the blood pressure. For this reason, it is avoided when managing hypotension in carcinoid disease. Instead, therapies that suppress mediator release, like octreotide, are used to control the crisis, and vasopressors such as norepinephrine or vasopressin are employed to support blood pressure without provoking additional mediator release.

In carcinoid disease, the tumor can release vasoactive substances such as serotonin, bradykinin, and histamine. Certain drugs can provoke the tumor to release these mediators, sparking or worsening a carcinoid crisis with profound hypotension and flushing. Epinephrine is a drug that can trigger further mediator release due to its broad adrenergic effects, which may worsen the crisis rather than stabilize the blood pressure. For this reason, it is avoided when managing hypotension in carcinoid disease. Instead, therapies that suppress mediator release, like octreotide, are used to control the crisis, and vasopressors such as norepinephrine or vasopressin are employed to support blood pressure without provoking additional mediator release.