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Preliminary observations on the use of midodrine in treating orthostatic hypotension in familial dysautonomia.
J Auton Nerv Syst. 1995 Oct 05; 55(1-2):29-35.JA

Abstract

Midodrine, a peripheral alpha-adrenergic agonist, was evaluated in 7 female and 2 male patients with familial dysautonomia (FD), a disorder characterized by decreased sympathetic innervation. Prior to and after three months of midodrine treatment, each patient's response to postural change was assessed by arteriosonde readings of blood pressure and heart rate, corrected QT-interval measurements, Doppler evaluation of renal blood flow and circulating atrial natriuretic peptide (ANP) levels. The initial midodrine dose (2.5 mg three times daily) was raised until subjective symptoms improved. Doses were reduced if patients felt jittery or developed erect hypertension (systolic > 180 mmHg or diastolic > 110 mmHg). Midodrine, at an average dose of 0.25 mg/kg per day, improved subjective symptoms in all patients. With treatment, magnitude of blood pressure responses was variable. Although mean erect blood pressure did not increase significantly for the aggregate, it did increase in six of nine patients. In addition, the QTc interval normalized and erect renal perfusion improved. Changes in supine mean blood pressure and supine circulating ANP correlated directly. We judge midodrine to be useful in management of orthostatic hypotension in patients with familial dysautonomia.

Authors+Show Affiliations

Department of Pediatrics, New York University Medical Center, NY 10016, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8690848

Citation

Axelrod, F B., et al. "Preliminary Observations On the Use of Midodrine in Treating Orthostatic Hypotension in Familial Dysautonomia." Journal of the Autonomic Nervous System, vol. 55, no. 1-2, 1995, pp. 29-35.
Axelrod FB, Krey L, Glickstein JS, et al. Preliminary observations on the use of midodrine in treating orthostatic hypotension in familial dysautonomia. J Auton Nerv Syst. 1995;55(1-2):29-35.
Axelrod, F. B., Krey, L., Glickstein, J. S., Allison, J. W., & Friedman, D. (1995). Preliminary observations on the use of midodrine in treating orthostatic hypotension in familial dysautonomia. Journal of the Autonomic Nervous System, 55(1-2), 29-35.
Axelrod FB, et al. Preliminary Observations On the Use of Midodrine in Treating Orthostatic Hypotension in Familial Dysautonomia. J Auton Nerv Syst. 1995 Oct 5;55(1-2):29-35. PubMed PMID: 8690848.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preliminary observations on the use of midodrine in treating orthostatic hypotension in familial dysautonomia. AU - Axelrod,F B, AU - Krey,L, AU - Glickstein,J S, AU - Allison,J W, AU - Friedman,D, PY - 1995/10/5/pubmed PY - 1995/10/5/medline PY - 1995/10/5/entrez SP - 29 EP - 35 JF - Journal of the autonomic nervous system JO - J Auton Nerv Syst VL - 55 IS - 1-2 N2 - Midodrine, a peripheral alpha-adrenergic agonist, was evaluated in 7 female and 2 male patients with familial dysautonomia (FD), a disorder characterized by decreased sympathetic innervation. Prior to and after three months of midodrine treatment, each patient's response to postural change was assessed by arteriosonde readings of blood pressure and heart rate, corrected QT-interval measurements, Doppler evaluation of renal blood flow and circulating atrial natriuretic peptide (ANP) levels. The initial midodrine dose (2.5 mg three times daily) was raised until subjective symptoms improved. Doses were reduced if patients felt jittery or developed erect hypertension (systolic > 180 mmHg or diastolic > 110 mmHg). Midodrine, at an average dose of 0.25 mg/kg per day, improved subjective symptoms in all patients. With treatment, magnitude of blood pressure responses was variable. Although mean erect blood pressure did not increase significantly for the aggregate, it did increase in six of nine patients. In addition, the QTc interval normalized and erect renal perfusion improved. Changes in supine mean blood pressure and supine circulating ANP correlated directly. We judge midodrine to be useful in management of orthostatic hypotension in patients with familial dysautonomia. SN - 0165-1838 UR - https://www.unboundmedicine.com/medline/citation/8690848/Preliminary_observations_on_the_use_of_midodrine_in_treating_orthostatic_hypotension_in_familial_dysautonomia_ DB - PRIME DP - Unbound Medicine ER -