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64) Central [alpha]-2 agonists (clonidine) may cause peripheral vasoconstriction via crossover stimulation of peripheral postsynaptic [alpha]-1 receptors, (65) while sympatholytics such as methyldopa (66) may cause transient hypertensive exacerbation before their hypotensive effects become manifest. Beta blockers, even the selective types, and oral decongestants can cause worsening peripheral vasoconstriction, and should be avoided; in the diabetic, beta blockers should be replaced by calcium channel blockers for angina or high blood pressure. An inspiratory gasp against resistance (Mueller maneuver) was used to cause a short sympathetic stimulus response which has been shown previously to be accompanied by peripheral vasoconstriction. |
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