Which medication follows alpha-blockade in the treatment order for pheochromocytoma?

In the management of pheochromocytoma, the treatment regimen typically begins with alpha-adrenergic blockade to control hypertension and prevent catecholamine-induced complications. Once adequate alpha-blockade is achieved, it is common to introduce a beta-blocker to manage any residual symptoms, particularly tachycardia.

Labetalol is a combined alpha and beta-adrenergic blocker, making it effective for this situation. By first providing alpha-blockade, the risk of hypertensive crises is minimized when a beta-blocker is administered. If beta-blockade is introduced without prior or concurrent alpha-blockade, it can lead to unopposed alpha receptor stimulation due to the blockade of the beta-adrenergic receptors, which can worsen hypertension and potentially lead to serious complications.

The other medications listed do not fit into the same approach for managing pheochromocytoma. Metoprolol is a selective beta-blocker and would not be used until alpha-blockade has been established, as would prazosin, which is also an alpha-blocker. Captopril, an ACE inhibitor, does not address the adrenergic imbalance caused by the excess catecholamines in pheochromocytoma. Thus, the choice of labetalol