Which medication class is a contraindication to nitroglycerin use due to potential severe hypotension?

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Multiple Choice

Which medication class is a contraindication to nitroglycerin use due to potential severe hypotension?

Explanation:
Nitroglycerin lowers blood pressure by releasing nitric oxide, which increases cGMP in smooth muscle and causes vasodilation, especially of the veins, reducing preload. The PDE-5 inhibitors, like sildenafil, block the breakdown of cGMP. When these two are used together, cGMP accumulates much more, leading to an exaggerated vasodilatory response and a potentially dangerous drop in blood pressure. This combination can cause severe hypotension, fainting, and even organ ischemia, so it is contraindicated. Other drug classes listed do not produce this same synergistic drop in blood pressure with nitrates, so they are not contraindicated in the same way.

Nitroglycerin lowers blood pressure by releasing nitric oxide, which increases cGMP in smooth muscle and causes vasodilation, especially of the veins, reducing preload. The PDE-5 inhibitors, like sildenafil, block the breakdown of cGMP. When these two are used together, cGMP accumulates much more, leading to an exaggerated vasodilatory response and a potentially dangerous drop in blood pressure. This combination can cause severe hypotension, fainting, and even organ ischemia, so it is contraindicated. Other drug classes listed do not produce this same synergistic drop in blood pressure with nitrates, so they are not contraindicated in the same way.

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