Question:
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?
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Block the endothelin receptor and you treat pulmonary arterial hypertension at its source.
Updated On: Jun 23, 2026
- Icatibant
- Bosentan
- Labetalol
- Sodium nitroprusside
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The Correct Option is B
Solution and Explanation
Answer: Bosentan.
Mechanism: Endothelin-1 is a powerful vasoconstrictor that is raised in pulmonary arterial hypertension (PAH). Bosentan is a non-selective endothelin receptor antagonist, so it blocks this pathway and lowers pulmonary vascular resistance. It is an approved disease-targeted therapy for PAH along with ambrisentan.
Why the others are wrong: Icatibant (A) is a bradykinin B2 receptor antagonist used for hereditary angioedema, not PAH. Labetalol (C) is an alpha/beta blocker for systemic hypertension and has no role in PAH. Sodium nitroprusside (D) is a non-selective systemic vasodilator used in hypertensive emergencies; it is not a standard chronic PAH agent and can drop systemic pressure dangerously.
Caution: Bosentan is hepatotoxic and is contraindicated with cyclosporine or glyburide. Liver enzymes must be monitored.
Ref: Harrison's Principles of Internal Medicine, 20e.
Mechanism: Endothelin-1 is a powerful vasoconstrictor that is raised in pulmonary arterial hypertension (PAH). Bosentan is a non-selective endothelin receptor antagonist, so it blocks this pathway and lowers pulmonary vascular resistance. It is an approved disease-targeted therapy for PAH along with ambrisentan.
Why the others are wrong: Icatibant (A) is a bradykinin B2 receptor antagonist used for hereditary angioedema, not PAH. Labetalol (C) is an alpha/beta blocker for systemic hypertension and has no role in PAH. Sodium nitroprusside (D) is a non-selective systemic vasodilator used in hypertensive emergencies; it is not a standard chronic PAH agent and can drop systemic pressure dangerously.
Caution: Bosentan is hepatotoxic and is contraindicated with cyclosporine or glyburide. Liver enzymes must be monitored.
Ref: Harrison's Principles of Internal Medicine, 20e.
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