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The Role of Midodrine for Hypotension Outside of the Intensive Care Unit.
J Popul Ther Clin Pharmacol. 2017 08 23; 24(3):e45-e50.JP

Abstract

Midodrine is an oral, peripherally acting alpha-adrenergic agonist. After gaining Food and Drug Administration (FDA) approval in 1996 for orthostatic hypotension, its use has evolved to target vasoplegic conditions such as intradialytic hypotension in the end-stage renal disease population, refractory ascites in cirrhotic patients to support diuresis, and in hepatorenal syndrome. Upon oral ingestion, the drug undergoes enzymatic hydrolysis to an active metabolite, desglymidodrine. Its use has been well tolerated at 2.5 mg, 5 mg, and 10 mg oral doses. The most frequently occurring side effects relate directly to its sympathomimetic profile and include piloerection, scalp pruritis, generalized paresthesias, and urinary retention. The vasoplegic profile of sepsis would be a potential target for midodrine therapy. While its use to mediate recovery from septic shock has been suggested, there is a paucity of clinical data supporting its use. Such therapy may be uniquely appropriate in septic patients who are not candidates for intensive care unit (ICU) level of care.

Authors+Show Affiliations

University of Calgary, Cumming School of Medicine, Calgary, Canada.University of Calgary, Cumming School of Medicine, Calgary, Canada.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

28873293

Citation

Gutman, Lawrence B., and Ben J. Wilson. "The Role of Midodrine for Hypotension Outside of the Intensive Care Unit." Journal of Population Therapeutics and Clinical Pharmacology = Journal De La Therapeutique Des Populations Et De La Pharmacologie Clinique, vol. 24, no. 3, 2017, pp. e45-e50.
Gutman LB, Wilson BJ. The Role of Midodrine for Hypotension Outside of the Intensive Care Unit. J Popul Ther Clin Pharmacol. 2017;24(3):e45-e50.
Gutman, L. B., & Wilson, B. J. (2017). The Role of Midodrine for Hypotension Outside of the Intensive Care Unit. Journal of Population Therapeutics and Clinical Pharmacology = Journal De La Therapeutique Des Populations Et De La Pharmacologie Clinique, 24(3), e45-e50. https://doi.org/10.22374/1710-6222.24.3.4
Gutman LB, Wilson BJ. The Role of Midodrine for Hypotension Outside of the Intensive Care Unit. J Popul Ther Clin Pharmacol. 2017 08 23;24(3):e45-e50. PubMed PMID: 28873293.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Role of Midodrine for Hypotension Outside of the Intensive Care Unit. AU - Gutman,Lawrence B, AU - Wilson,Ben J, Y1 - 2017/08/23/ PY - 2017/02/11/received PY - 2017/9/6/entrez PY - 2017/9/6/pubmed PY - 2018/5/10/medline KW - hypotension KW - midodrine KW - sepsis KW - vasoplegia SP - e45 EP - e50 JF - Journal of population therapeutics and clinical pharmacology = Journal de la therapeutique des populations et de la pharmacologie clinique JO - J Popul Ther Clin Pharmacol VL - 24 IS - 3 N2 - Midodrine is an oral, peripherally acting alpha-adrenergic agonist. After gaining Food and Drug Administration (FDA) approval in 1996 for orthostatic hypotension, its use has evolved to target vasoplegic conditions such as intradialytic hypotension in the end-stage renal disease population, refractory ascites in cirrhotic patients to support diuresis, and in hepatorenal syndrome. Upon oral ingestion, the drug undergoes enzymatic hydrolysis to an active metabolite, desglymidodrine. Its use has been well tolerated at 2.5 mg, 5 mg, and 10 mg oral doses. The most frequently occurring side effects relate directly to its sympathomimetic profile and include piloerection, scalp pruritis, generalized paresthesias, and urinary retention. The vasoplegic profile of sepsis would be a potential target for midodrine therapy. While its use to mediate recovery from septic shock has been suggested, there is a paucity of clinical data supporting its use. Such therapy may be uniquely appropriate in septic patients who are not candidates for intensive care unit (ICU) level of care. SN - 2561-8741 UR - https://www.unboundmedicine.com/medline/citation/28873293/The_Role_of_Midodrine_for_Hypotension_Outside_of_the_Intensive_Care_Unit_ L2 - https://medlineplus.gov/lowbloodpressure.html DB - PRIME DP - Unbound Medicine ER -