Oneliner_2293

OneLiner

The medical management of pheochromocytoma involves sequential administration of α-blockers first followed by ß- blockers after adequate α-blockade is established. The α-blockers prevent peripheral vasoconstriction while ß-blockers decrease cardiac contractility and heart rate while also inhibiting smooth muscle relaxation of the arterial walls. This inhibition of vasodilation is the reason why it is crucial that α-blockers are administered prior to ß-blockers: if there is any massive catecholamine release, sole inhibition of ß-receptors impairs vasodilation while α-agonism is unrestrained and this results in unopposed vasoconstriction and hypertensive crisis. Medical management is typically not a long-term measure but rather a preoperative adjunct to surgical excision which is definitive treatment.