Which of the following medications should be avoided in a 61-year-old patient with a history of hypertension and NSTEMI?

The choice to avoid an oral decongestant in a 61-year-old patient with a history of hypertension and NSTEMI is based on the pharmacological effects of these medications. Oral decongestants, such as pseudoephedrine, can cause vasoconstriction and increase blood pressure by stimulating alpha-adrenergic receptors. This effect can be particularly concerning in patients with a history of hypertension or cardiovascular conditions like NSTEMI, as it may exacerbate their existing health issues, potentially leading to complications.

In contrast, other options such as antihistamine nasal sprays, leukotriene modifiers, and intranasal corticosteroids do not typically have the same hypertensive effects and may be safer alternatives for managing symptoms like nasal congestion in this patient population. Antihistamine nasal sprays generally work locally with minimal systemic absorption, while leukotriene modifiers and intranasal corticosteroids target inflammation without significantly impacting blood pressure.

Therefore, avoiding oral decongestants in this context is a cautious approach to minimize the risk of worsening hypertension and potential cardiac events.