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Midodrine, sold under the brand names ProAmatine and Orvaten among others, is a vasopressor or antihypotensive medication used to treat orthostatic hypotension (low blood pressure when standing) and urinary incontinence. [3] [5] [1] It is taken by mouth. [3] [1]
Patients with NOH have depleted levels of norepinephrine which leads to decreased blood pressure or hypotension upon orthostatic challenge. [14] Droxidopa works by increasing the levels of norepinephrine in the peripheral nervous system (PNS), thus enabling the body to maintain blood flow upon and while standing. [14]
Fludrocortisone is the first-line therapy (in the absence of heart failure) for patients with chronic hypotension or resistant orthostatic hypotension. [17] It works by increasing the intravascular volume. [17] Midodrine is a therapy used for severe orthostatic hypotension, and works by increasing peripheral vascular resistance. [17]
Orthostatic syncope refers to syncope resulting from a postural decrease in blood pressure, termed orthostatic hypotension. [1]Orthostatic hypotension occurs when there is a persistent reduction in blood pressure of at least 20mmHg systolic or 10mmHg diastolic within three minutes of standing or being upright to 60 degrees on the head-up tilt table.
Patients prone to orthostatic hypotension are the elderly, post partum mothers, and those having been on bed rest. People with anorexia nervosa and bulimia nervosa often develop orthostatic hypotension as a common side effect. Consuming alcohol may also lead to orthostatic hypotension due to its dehydrating effects. [citation needed]
Within three minutes of standing up straight, orthostatic hypotension is defined as a drop in systolic blood pressure of at least 20 mm Hg or a drop in diastolic blood pressure of 10 mm Hg. [7] About half of PAF patients also have concurrent supine hypertension, even though all PAF patients by definition have orthostatic hypotension. [8]
Orthostatic intolerance (OI) is the development of symptoms when standing upright that are relieved when reclining. [1] There are many types of orthostatic intolerance. OI can be a subcategory of dysautonomia , a disorder of the autonomic nervous system [ 2 ] occurring when an individual stands up. [ 3 ]
Desglymidodrine (developmental code name ST-1059) is the active metabolite of the prodrug antihypotensive agent midodrine. [1] [2] [3] It acts as a selective α 1-adrenergic receptor agonist. [1] [2] [3] Desglymidodrine is formed from midodrine via deglycination. [1] [2] [3]