Cough Reflex Test (CRT) Practice

Which medication is commonly recommended to lower systemic arterial blood pressure and decrease ventricular preload?

1. Atenolol

2. Sodium nitroprusside (Nipride)

3. Lisinopril

4. Furosemide

The correct answer is: Sodium nitroprusside (Nipride)

Sodium nitroprusside, commonly referred to as Nipride, is a potent vasodilator used specifically to lower systemic arterial blood pressure quickly. It works by relaxing the smooth muscle in blood vessels, leading to dilation, which decreases peripheral resistance. This action reduces the pressure the heart must work against during pumping, effectively lowering ventricular preload. The quick onset of Sodium nitroprusside makes it particularly useful in acute hypertensive crises where rapid blood pressure control is necessary. While other medications listed can also impact blood pressure and preload, Sodium nitroprusside is uniquely effective for immediate results in emergency situations. For example, atenolol is a beta-blocker that primarily acts on heart rate and contractility but may not provide quick vascular effects. Lisinopril, an ACE inhibitor, helps to lower blood pressure and reduce preload over a longer duration. Furosemide is a diuretic that reduces blood volume and may lower preload, but it does not have the direct vasodilatory effects seen with Sodium nitroprusside. Thus, in terms of rapid and effective reduction of systemic arterial blood pressure and ventricular preload, Sodium nitroprusside is the medication of choice.