WBR0759

Author	[[PageAuthor::Yazan Daaboul, M.D. (Reviewed by Yazan Daaboul, M.D.)]]
Exam Type	USMLE Step 1
Main Category	Pharmacology
Sub Category	Vascular, General Principles
Prompt	A 45-year-old man with no past medical history presents to the physician's office for hair loss. Upon further questioning, the patient explains that he has a strong family history of alopecia. Physical examination is remarkable for male pattern baldness with no evidence of skin disease. The physician prescribes a topical medication to reduce the patient's hair loss. The patient then asks if he can use the same drug in an oral preparation instead, but the physician explains that oral administration of the drug is indicated for another disease. What is the indication for the oral form of the prescribed topical solution?
Answer A	Dyslipidemia
Answer A Explanation	Oral minoxidil is not used to treat dyslipidemia.
Answer B	Atopic dermatitis
Answer B Explanation	Oral minoxidil is not used to treat atopic dermatitis.
Answer C	Hypertension
Answer C Explanation	Oral minoxidil is used to treat severe refractory hypertension.
Answer D	Psoriasis
Answer D Explanation	Oral minoxidil is not used to treat psoriasis.
Answer E	Anemia
Answer E Explanation	Oral minoxidil is not used to treat anemia.
Right Answer	C
Explanation	Minoxidil is a potent vasodilator indicated for the management of hypertension. Although initially manufactured for its antihypertensive effects, it was then discovered to cause hair growth. Topical minoxidil is currently manufactured and indicated for male pattern baldness. Compliance with the topical agent is difficult because it requires daily application, whereas the sustained benefit is only observed if the drug is applied daily and consistently. Oral minoxidil is still used for severe refractory cases of hypertension; although its use has generally decreased given the availability of other potent and safer drugs and its association with serious cardiac adverse events. Educational Objective: Topical minoxidil may be applied daily to treat male-pattern baldness. In contrast, oral minoxidil is indicated for severe refractory hypertension. References: Storer JS, Brzuskiewicz J, Floyd H, et al. Topical minoxidil for male pattern baldness. Am J Med Sci. 1986;291(5)
Approved	Yes
Keyword	Minoxidil, Hypertension, Male pattern baldness, Oral, Topical, Antihypertensive, Alopecia, Androgenic hair loss, Hair
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