Pheochromocytoma - Revision history

Danbot: Add MedicationDose SMW entry for phentolamine; dose verified against endocrine emergency guidelines

2026-03-20T18:01:27Z

Add MedicationDose SMW entry for phentolamine; dose verified against endocrine emergency guidelines

← Older revision		Revision as of 18:01, 20 March 2026
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	**If beta blockade started before alpha blockers, unopposed alpha activity can precipitate [[hypertensive emergency]]		**If beta blockade started before alpha blockers, unopposed alpha activity can precipitate [[hypertensive emergency]]
	*Eventual surgical resection of tumor		*Eventual surgical resection of tumor


			==Medication Dosing==
			*{{MedicationDose\|drug=Phentolamine\|dose=5 mg q2-4hr PRN\|route=IV/IM\|context=Alpha-blocker for hypertensive crisis\|indication=Pheochromocytoma\|population=Adult\|notes=Must achieve alpha blockade before beta blockade}}

	==Disposition==		==Disposition==

2022-08-20T06:08:35Z

Evaluation

← Older revision		Revision as of 06:08, 20 August 2022
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	*Plasma free metanephrines		*Plasma free metanephrines
	*Urinary fractionated metanephrines		*Urinary fractionated metanephrines
	*CT imaging to localize tumor		*Plasma and urine catecholamines
			*CT with adrenal protocol imaging to localize tumor
			*PET scan may eventually be required
	*General lab features include hyperglycemia, hypercalcemia, and erythrocytosis		*General lab features include hyperglycemia, hypercalcemia, and erythrocytosis

2021-02-01T20:09:19Z

Management

← Older revision		Revision as of 20:09, 1 February 2021
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	**[[Nicardipine]]		**[[Nicardipine]]
	*[[beta blockers\|Beta blockade]] can be started 2 days later		*[[beta blockers\|Beta blockade]] can be started 2 days later
			**If beta blockade started before alpha blockers, unopposed alpha activity can precipitate [[hypertensive emergency]]
	*Eventual surgical resection of tumor		*Eventual surgical resection of tumor

2021-01-15T22:46:24Z

Clinical Features

← Older revision		Revision as of 22:46, 15 January 2021
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	*Paroxysms usually lasting <1 hour of the following symptoms:		*Paroxysms usually lasting <1 hour of the following symptoms:
	**[[Headache]]		**[[Headache]]
			**[[Tremor]]
	**Alternating periods of normal and elevated blood pressure, and can cause resistant [[hypertension]] and [[hypertensive emergency]]		**Alternating periods of normal and elevated blood pressure, and can cause resistant [[hypertension]] and [[hypertensive emergency]]
	**[[Tachycardia]]		**[[Tachycardia]]

2021-01-15T22:45:29Z

Clinical Features

← Older revision		Revision as of 22:45, 15 January 2021
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	==Clinical Features==		==Clinical Features==
	*[[Headache]]		*Paroxysms usually lasting <1 hour of the following symptoms:
	*Alternating periods of normal and elevated blood pressure, and can cause resistant [[hypertension]] and [[hypertensive emergency]]		**[[Headache]]
	*[[Tachycardia]]		**Alternating periods of normal and elevated blood pressure, and can cause resistant [[hypertension]] and [[hypertensive emergency]]
	*Flushed skin		**[[Tachycardia]]
	*[[Palpitations]]		**Flushed skin
	*Diaphoresis		**[[Palpitations]]
			**Diaphoresis
			**Anxiety
	*Weight loss		*Weight loss
	*Episodic anxiety

	==Differential Diagnosis==		==Differential Diagnosis==

2019-09-28T16:50:57Z

Management

← Older revision		Revision as of 16:50, 28 September 2019
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	==Management==		==Management==
	*Hypertensive crisis:		*Hypertensive crisis:
	** α blockade with phenoxybenzamine or phentolamine acutely<ref>WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)</ref>		**[[alpha blockers\|α blockade]] with phenoxybenzamine or [[phentolamine]] acutely<ref>WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)</ref>
	** ~~nitroprusside~~		***[[Phentolamine]]: 5mg IM/IV q2-4h PRN
	** ~~nicardipine~~		**[[Nitroprusside]]
	*Beta blockade can be started 2 days later		**[[Nicardipine]]
			*[[beta blockers\|Beta blockade]] can be started 2 days later
	*Eventual surgical resection of tumor		*Eventual surgical resection of tumor

2019-02-13T13:10:39Z

Clinical Features

2018-01-22T23:59:29Z

Management

← Older revision		Revision as of 23:59, 22 January 2018
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	==Management==		==Management==
	*α blockade with phenoxybenzamine or phentolamine acutely<ref>WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)</ref>		*Hypertensive crisis:
			** α blockade with phenoxybenzamine or phentolamine acutely<ref>WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)</ref>
			** nitroprusside
			** nicardipine
	*Beta blockade can be started 2 days later		*Beta blockade can be started 2 days later
	*Eventual surgical resection of tumor		*Eventual surgical resection of tumor

2017-07-24T01:12:32Z

Text replacement - "Alpha" to "α"

← Older revision		Revision as of 01:12, 24 July 2017
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	==Management==		==Management==
	*~~Alpha~~ blockade with phenoxybenzamine or phentolamine acutely<ref>WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)</ref>		*α blockade with phenoxybenzamine or phentolamine acutely<ref>WJ Elliott, J Varon. Drugs used for the treatment of hypertensive emergencies. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on January 11, 2016.)</ref>
	*Beta blockade can be started 2 days later		*Beta blockade can be started 2 days later
	*Eventual surgical resection of tumor		*Eventual surgical resection of tumor

2016-07-25T02:12:58Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 02:12, 25 July 2016
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	{{Hypertension DDX}}		{{Hypertension DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Plasma free metanephrines		*Plasma free metanephrines
	*Urinary fractionated metanephrines		*Urinary fractionated metanephrines