Pseudoephedrine is commonly used for nasal congestion but should be avoided in patients with which condition?

• A. Asthma
• B. Hypertension
• C. Cardiac disease
• D. Diabetes

Answer: (D)

Pseudoephedrine is a systemic decongestant that works by stimulating alpha-adrenergic receptors to constrict nasal blood vessels, and it can also increase heart rate and blood pressure. The safety test here focuses on how this stimulant interacts with conditions that can be affected by these sympathetic effects.

In diabetes, these sympathomimetic effects can make blood glucose control more difficult. Pseudoephedrine can raise blood glucose levels and potentially interfere with how antihyperglycemic medications work. It can also mask or mimic hypoglycemia symptoms, which can complicate recognizing low blood sugar. Because of these risks, using pseudoephedrine in people with diabetes requires caution or avoiding it altogether, with safer alternatives like saline sprays or non-systemic decongestants considered instead.

The other conditions listed are more directly linked to concerns about blood pressure and cardiac workload (hypertension and cardiac disease), where decongestants with systemic vasoconstrictive effects are typically avoided. Asthma is not a contraindication in itself and may even see some bronchodilatory effects, so it’s not the best fit for avoidance in the way diabetes is in this context.