Final answer:
Uncontrolled hypertension contraindicates the use of adrenergic or cholinergic drugs due to their effects on the cardiovascular system. Adrenergic drugs may worsen hypertension by stimulating the sympathetic nervous system, while sympatholytic drugs like beta blockers can help manage it but need to be used carefully to prevent serious side effects. On the contrary, ACE inhibitors and other antihypertensive medications are safer alternatives for managing high blood pressure.
Step-by-step explanation:
Uncontrolled hypertension is a condition where blood pressure remains high despite efforts to lower it. When treating hypertension, it's crucial to consider drug interactions and contraindications. In particular, adrenergic and cholinergic drugs can interact with the autonomic nervous system, affecting the cardiovascular system.
Adrenergic drugs, such as sympathomimetics, stimulate the sympathetic nervous system leading to increased heart rate and contraction force, potentially exacerbating hypertension. For example, norepinephrine (NE) binds to the beta-1 receptor, increasing heart rate. Conversely, sympatholytic drugs, like beta blockers, work by blocking these receptors, thereby reducing heart rate and are commonly used to treat hypertension. Overuse of beta blockers, however, may lead to adverse effects such as bradycardia or even heart stoppage.
Cholinergic drugs affect the parasympathetic nervous system and modify bodily functions regulated by this system. Some of these drugs could potentially decrease blood pressure, but in a patient with uncontrolled hypertension, the effects might be unpredictable and potentially harmful. Moreover, tumors like pheochromocytomas can cause an overproduction of catecholamines leading to severe hypertension, which may be aggravated by adrenergic drugs.
Individuals with hypertension may be treated with drugs that block angiotensin II production, such as ACE inhibitors, which prevent the formation of this potent vasoconstrictor. Antihypertensive medications also include thiazide-diuretics, calcium channel blockers, and angiotensin receptor blockers (ARBs), which are chosen based on a stepped care approach to reach target blood pressure levels.