In elderly patients, which issue is a concern with sympathomimetic decongestants such as pseudoephedrine and phenylephrine?

In elderly patients, which issue is a concern with sympathomimetic decongestants such as pseudoephedrine and phenylephrine?

• A. Worsen existing urinary obstruction
• B. Improve urinary flow
• C. Cause hyperglycemia only in diabetics
• D. Cause persistent cough

Answer: (A)

Sympathomimetic decongestants act as alpha-adrenergic agonists, which not only constrict nasal vessels but also tighten smooth muscle at the bladder outlet. In older adults, especially those with benign prostatic hyperplasia or other bladder outlet issues, this alpha-1–mediated contraction can worsen urinary obstruction and lead to increased residual urine or acute urinary retention. That makes this a real and common concern in the elderly. The other ideas don’t fit as well: these medications don’t improve urinary flow; hyperglycemia is not limited to diabetics and is not the primary issue in this context; and persistent cough is not a typical effect of these decongestants.

Sympathomimetic decongestants act as alpha-adrenergic agonists, which not only constrict nasal vessels but also tighten smooth muscle at the bladder outlet. In older adults, especially those with benign prostatic hyperplasia or other bladder outlet issues, this alpha-1–mediated contraction can worsen urinary obstruction and lead to increased residual urine or acute urinary retention. That makes this a real and common concern in the elderly.

The other ideas don’t fit as well: these medications don’t improve urinary flow; hyperglycemia is not limited to diabetics and is not the primary issue in this context; and persistent cough is not a typical effect of these decongestants.