Which of the following should be avoided in Raynaud's phenomenon due to vasoconstriction?

• A. Imitrex (Sumatriptan)
• B. Pseudoephedrine
• C. Amphetamines
• D. All of the Above

Answer: (D)

Raynaud's phenomenon involves episodic vasospasm of small digital arteries in response to cold or stress. Drugs that cause vasoconstriction can worsen these attacks, so they should be avoided. Sumatriptan constricts peripheral vessels by activating serotonin receptors, which can aggravate digital vasospasm. Pseudoephedrine stimulates alpha-adrenergic receptors, leading to peripheral vasoconstriction. Amphetamines increase sympathetic nervous system activity and norepinephrine release, resulting in vasoconstriction as well. Because each of these can provoke or worsen vasospasm, all of them are best avoided in Raynaud's. For management, focus on warming the hands and avoiding triggers, and consult a clinician about safer migraine or decongestant options; calcium channel blockers are commonly used to prevent episodes if appropriate.