Contrasting actions of pressor agents in severe autonomic failure.

摘要: BACKGROUND: Orthostatic hypotension is the most disabling symptom of autonomic failure. The choice a pressor agent largely empiric, and it would be great value to define predictors response. PATIENTS AND METHODS: In 35 patients with severe orthostatic due multiple system atrophy or pure failure, we determined effect on seated systolic blood pressure (SBP) placebo, phenylpropanolamine (12.5 mg 25 mg), yohimbine (5.4 indomethacin (50 ibuprofen (600 caffeine (250 methylphenidate (5 mg). subgroup patients, compared midodrine mg) RESULTS: There were no significant differences in responses between When response was for phenylpropanolamine, yohimbine, indomethacin. confirmed that this corresponded increase standing SBP. ibuprofen, caffeine, not significantly different from placebo. Phenylpropanolamine elicited similar responses. associations drug function testing, postprandial hypotension, plasma catecholamine levels. CONCLUSIONS: We conclude increases can obtained primary failure low doses moderate doses. cannot predicted by testing catecholamines. Therefore, empiric sequence medications, based risk side effects individual patient probability response, useful approach.