What medication should be discontinued in a patient experiencing orthostatic light-headedness?

• A. Atenolol
• B. Lisinopril
• C. Furosemide
• D. Clonidine

Answer: (A)

Atenolol, a beta-blocker, is known to cause or exacerbate symptoms of orthostatic hypotension, including light-headedness upon standing. In patients who are sensitive to changes in blood pressure, especially the elderly or those with preexisting conditions, beta-blockers can inhibit the body's ability to regulate heart rate and blood vessel constriction appropriately. This can lead to a significant drop in blood pressure when shifting from a sitting or lying position to standing, resulting in orthostatic light-headedness.

When faced with a patient exhibiting these symptoms, discontinuing atenolol may help to alleviate the issue by reducing the likelihood of further drops in blood pressure. This is particularly relevant in cases where the patient's symptoms are directly attributable to the medication's side effects rather than other underlying health concerns.

In contrast, medications like lisinopril, a common ACE inhibitor, may also affect blood pressure but tend to be used in the management of hypertension and heart failure with a different side effect profile. Furosemide, a diuretic, can lead to dehydration and electrolyte imbalances that may also affect blood pressure but is not typically the direct cause of orthostatic light-headedness in the same manner as beta-blockers. Clonidine