Autonomic nervous system: midodrine: 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 · Autonomic nervous system: midodrine

Sample item

A 62-year-old with autonomic failure has marked fall in blood pressure on standing. An oral prodrug whose metabolite is an alpha-1 agonist is started. Which drug is it?

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

The answer and the reasoning

C. Midodrine

Midodrine is converted to desglymidodrine, an alpha-1 agonist that constricts arterioles and veins and raises standing blood pressure. Supine hypertension is the main risk, so it is taken in the daytime and avoided near bedtime.

Option by option

  • A. Methyldopa

    Methyldopa reduces sympathetic outflow and would aggravate hypotension.

  • B. Labetalol

    Labetalol blocks alpha and beta receptors and lowers blood pressure.

  • C. Midodrine (correct)

    Correct. Midodrine is the alpha-1 agonist prodrug used for orthostatic hypotension.

  • D. Prazosin

    Prazosin blocks alpha-1 receptors and would worsen the postural fall.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Midodrine. Midodrine is converted to desglymidodrine, an alpha-1 agonist that constricts arterioles and veins and raises standing blood pressure.

Why is "Methyldopa" not the answer?

Methyldopa reduces sympathetic outflow and would aggravate hypotension.

Why is "Labetalol" not the answer?

Labetalol blocks alpha and beta receptors and lowers blood pressure.

Why is "Prazosin" not the answer?

Prazosin blocks alpha-1 receptors and would worsen the postural fall.

What concept does this question test?

It tests Autonomic nervous system: midodrine in Pharmacology. Supine hypertension is the main risk, so it is taken in the daytime and avoided near bedtime.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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 Autonomic nervous system: midodrine?

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.