Long-term management of phaeochromocytoma involves surgery. Alpha-blockers are used in the short-term management of hypertensive episodes in phaeochromocytoma. Once alpha blockade is established, tachycardia can be controlled by the cautious addition of a beta-blocker a cardioselective beta-blocker is preferred.
Phenoxybenzamine, a powerful alpha-blocker, is effective in the management of phaeochromocytoma but it has many side-effects. Phentolamine is a short-acting alpha-blocker used mainly during surgery of phaeochromocytoma; its use for the diagnosis of phaeochromocytoma has been superseded by measurement of catecholamines in blood and urine.
Metirosine inhibits the enzyme tyrosine hydroxylase, and hence the synthesis of catecholamines. It is rarely used in the pre-operative management of phaeochromocytoma, and long term in patients unsuitable for surgery; an alpha-adrenoceptor blocking drug may also be required. Metirosine should not be used to treat essential hypertension.
Phenoxybenzamine, a powerful alpha-blocker, is effective in the management of phaeochromocytoma but it has many side-effects. Phentolamine is a short-acting alpha-blocker used mainly during surgery of phaeochromocytoma; its use for the diagnosis of phaeochromocytoma has been superseded by measurement of catecholamines in blood and urine.
Metirosine inhibits the enzyme tyrosine hydroxylase, and hence the synthesis of catecholamines. It is rarely used in the pre-operative management of phaeochromocytoma, and long term in patients unsuitable for surgery; an alpha-adrenoceptor blocking drug may also be required. Metirosine should not be used to treat essential hypertension.
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