Treatment of orthostatic hypotension is -
Ans. is 'c' i.e., Fludrocortisone Management of chronic orthostatic hypotensiono Correct precipitating factors (e.g,, hypovolemia) and withdraw offending drugs (diuretics, vasodilators, tranquilizers and sedatives)Physical measureso Raise the head of the bed by 10 to 20dego Arise slowly, in stages, from supine to seated to standingo Dors (flexion of the feet, handgrip isometric, leg cross ing/squatting before standingo Liberalize salt and fluid intakeo Small meals and coffee only in the early morningo Jobst stockings and pressure suits (often not acceptable)Drugso Fludrocortisone with a high salt diet is the initial treatment of choiceo Sympathomimetic drugs - ephedrine, phenylpropanolamine, pseudoephedrine, phenylephrine, midodrine, methylphenidate, dextroamphetamineo Supplemtary agentsNonsteroidal antiinflammatory drugsCaffeineErythropoietin (if anemic)o Third-line and experimental drugsVasopressin receptor agonistd-dDA VP, lysine vasopressinPyridostigmineYohimbineSomatostatin analogues - octreotide, especially for postprandial hypotension DihydroergotamineFluoxetineDihydroxyphenylserineDopamine antagonists - metocloramide, domperidoneMonoamine oxidase inhibitor with tyramine - can produce severe hypertension.
Dopamine
Diuretics
Fludrocortisone
Calcium channel blockers
Drugs