Antihypertensives: minoxidil co-prescription: 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.

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Pharmacology · Antihypertensives: minoxidil co-prescription

Sample item

A 50-year-old man with severe resistant hypertension and chronic kidney disease is started on minoxidil. The physician also prescribes a beta-blocker and a loop diuretic. What is the purpose of adding both?

ATo prevent hyperkalaemia and hyponatraemiaBTo prevent hirsutism and gingival hyperplasiaCTo prevent cough and angioedemaDTo counter reflex tachycardia and sodium and water retention caused by arteriolar dilatation

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

The answer and the reasoning

D. To counter reflex tachycardia and sodium and water retention caused by arteriolar dilatation

Minoxidil opens ATP-sensitive potassium channels and strongly dilates arterioles. This provokes reflex sympathetic tachycardia and renal salt and water retention, so a beta-blocker and a diuretic are given with it. Hypertrichosis and pericardial effusion are other effects.

Option by option

A. To prevent hyperkalaemia and hyponatraemia
Minoxidil does not cause hyperkalaemia, and a loop diuretic would tend to lower potassium.
B. To prevent hirsutism and gingival hyperplasia
Hirsutism is a direct effect of minoxidil that these drugs do not prevent.
C. To prevent cough and angioedema
Cough and angioedema are effects of ACE inhibitors, not minoxidil.
D. To counter reflex tachycardia and sodium and water retention caused by arteriolar dilatation (correct)
Correct. The beta-blocker blunts reflex tachycardia and the loop diuretic offsets fluid retention.

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.

Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, To counter reflex tachycardia and sodium and water retention caused by arteriolar dilatation. Minoxidil opens ATP-sensitive potassium channels and strongly dilates arterioles.

Why is "To prevent hyperkalaemia and hyponatraemia" not the answer?

Minoxidil does not cause hyperkalaemia, and a loop diuretic would tend to lower potassium.

Why is "To prevent hirsutism and gingival hyperplasia" not the answer?

Hirsutism is a direct effect of minoxidil that these drugs do not prevent.

Why is "To prevent cough and angioedema" not the answer?

Cough and angioedema are effects of ACE inhibitors, not minoxidil.

What concept does this question test?

It tests Antihypertensives: minoxidil co-prescription in Pharmacology. This provokes reflex sympathetic tachycardia and renal salt and water retention, so a beta-blocker and a diuretic are given with it. Hypertrichosis and pericardial effusion are other effects.

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 Antihypertensives: minoxidil co-prescription?

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.