Question:medium
Which of the following drugs can be given in patients of primary pulmonary hypertension?
Which of the following drugs can be given in patients of primary pulmonary hypertension?
Show Hint
Block the endothelin receptor and you treat pulmonary arterial hypertension at its source.
Updated On: Jun 23, 2026
- Icatibant
- Bosentan
- Labetalol
- Sodium nitroprusside
Show Solution
The Correct Option is B
Solution and Explanation
Drug class first: The four approved pillars of PAH therapy are endothelin receptor antagonists, phosphodiesterase-5 inhibitors, prostacyclin analogues and the soluble guanylate cyclase stimulator riociguat. Scan the options for one of these classes.
Option elimination: Icatibant treats hereditary angioedema by blocking bradykinin, no link to lung vessels, so it goes. Labetalol is a routine antihypertensive beta/alpha blocker with no PAH indication, so it goes. Sodium nitroprusside is an emergency systemic vasodilator, not a chronic PAH drug, so it goes. That leaves bosentan.
Why bosentan fits: It antagonises endothelin receptors. Endothelin is up in PAH and drives pulmonary vasoconstriction and remodelling, so blocking it directly targets the disease, which is why it is a licensed therapy.
Exam pearl: Remember bosentan = endothelin blocker = liver monitoring needed, and it is teratogenic, so it is given with contraception in women of childbearing age.
Ref: Harrison's Principles of Internal Medicine, 20e.
Option elimination: Icatibant treats hereditary angioedema by blocking bradykinin, no link to lung vessels, so it goes. Labetalol is a routine antihypertensive beta/alpha blocker with no PAH indication, so it goes. Sodium nitroprusside is an emergency systemic vasodilator, not a chronic PAH drug, so it goes. That leaves bosentan.
Why bosentan fits: It antagonises endothelin receptors. Endothelin is up in PAH and drives pulmonary vasoconstriction and remodelling, so blocking it directly targets the disease, which is why it is a licensed therapy.
Exam pearl: Remember bosentan = endothelin blocker = liver monitoring needed, and it is teratogenic, so it is given with contraception in women of childbearing age.
Ref: Harrison's Principles of Internal Medicine, 20e.
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