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A patient is admitted to the emergency department with severe tachycardia after a drug overdose. His family reports that he has been depressed about his hypertension. Which one of the follow ing drugs increases the heart rate in a dose-dependent manner?
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Commit #268356
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(A) Captopril
(B) Hydrochlorothiazide
(C) Losartan
(D) Minoxidil
(E) Verapamil
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ACE inhibitors (choice A), ARBs (choice C), and diuretics (choice B) do not significantly increase heart rate. Although dihydropyridine calcium channel blockers do not usually reduce rate markedly (and may increase it), verapamil (choice E) and diltiazem do inhibit the sinoatrial node and predict ably decrease rate. Other direct vasodilators (choice D) reg ularly inmase heart rate, and minoxidil, a very efficacious vasodilator, may cause severe tachycardia that must be con trolled with ~ blockers. The answer is D.