Treatment of ohostatic hypotension includes all except: March 2010
Ans. C: Dopamine Ohostatic hypotension It is defined as sustained drop in systolic (at least 20 mm Hg) or diastolic (at least 10 mm Hg) BP within 3 minutes of standing. The first steps in treatment of ohostatic hypotension are diagnosis and management of the underlying cause. A patient with symptomatic ohostatic hypotension who has a disease with no complete or specific cure may benefit from nonpharmacologic interventions which includes: Increasing salt and fluid intake Elevate head of bed Learn physical countermaneuvers like sitting leg-crossing Compression garments Drug treatment if these measures are not sufficient includes: Prostaglandin inhibitors (ibuprofen/ indomethacin) drugs can be used to increase intravascular volume. The mineralocoicoid fludrocoisone may be used in some patients to expand intravascular volume. Its side effect is supine hypeension. Midodrine (alpha-1 agonist), a vasoconstrictor, is effective in some cases of ohostatic hypotension.Its side effect is supine hypeension. Erythropoietin has been used to treat autonomic failure associated with decreased red cell mass or anemia. Pyridostigmine appears to improve ohostatic hypotension without aggravating supine hypeension. Other agents used are Octreotide, hydralazine, procardia or nitroglycerin patch.
High salt and fluid intake
Physical countermaneuvers
Dopamine
Fludricoisone