Which decongestant is commonly associated with stimulating effects and potential blood pressure rise?

• A. Pseudoephedrine
• B. Phenylephrine
• C. Diphenhydramine
• D. Oxymetazoline

Answer: (A)

Decongestants that stimulate the sympathetic nervous system can raise blood pressure. Pseudoephedrine stands out because it increases norepinephrine release and also has some direct alpha-adrenergic activity, leading to both central stimulant effects (like restlessness or insomnia) and peripheral vasoconstriction that can elevate blood pressure. This combination makes it the classic decongestant associated with stimulating effects and BP rise.

Phenylephrine also causes vasoconstriction via alpha-1 receptors, so it can raise blood pressure, but it tends to have less CNS stimulation and is often less impactful on mood or alertness compared with pseudoephedrine. Diphenhydramine is largely sedating, not stimulating. Oxymetazoline is typically used topically and has minimal systemic absorption, so it’s unlikely to produce stimulating effects or a BP rise.