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https://www.readbyqxmd.com/read/28681510/impact-of-drugs-on-intradialytic-hypotension-antihypertensives-and-vasoconstrictors
#1
Tara I Chang
Intradialytic hypotension (IDH) is a common complication of hemodialysis and is associated with numerous adverse outcomes including cardiovascular events, inadequate dialysis, loss of vascular access, and death. It is estimated that approximately 20%-30% of all dialysis sessions are affected by IDH. In seeking ways to reduce the occurrence of IDH, dialysis providers often turn to pharmacological approaches: withholding antihypertensive medications prior to hemodialysis or administering vasoconstrictor medications...
July 5, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28577744/orthostatic-hypotension-a-review
#2
Adrien Joseph, Ruben Wanono, Martin Flamant, Emmanuelle Vidal-Petiot
Orthostatic hypotension, defined by a drop in blood pressure of at least 20mmHg for systolic blood pressure and at least 10mmHg for diastolic blood pressure within 3minutes of standing up, is a frequent finding, particularly in elderly patients. It is associated with a significant increase in morbidity and mortality. Although it is often multifactorial, the first favoring factor is medications. Other etiologies are divided in neurogenic orthostatic hypotension, characterized by autonomic failure due to central or peripheral nervous system disorders, and non-neurogenic orthostatic hypotension, mainly favoured by hypovolemia...
April 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28468013/translating-our-current-understanding-of-ascites-management-into-new-therapies-for-patients-with-cirrhosis-and-fluid-retention
#3
Elisa Pose, Andres Cardenas
Ascites is the most common complication associated with cirrhosis resulting in poor quality of life, high risk of development of other complications of cirrhosis, increased morbidity and mortality associated with surgical interventions, and poor long-term outcome. Patients with cirrhosis and a first onset of ascites, have a probability of survival of 85% during the first year and 56% at 5 years without liver transplantation. Ascites is caused due to increased renal sodium retention as a result of increased activity of the renin-angiotensin-aldosterone system in response to marked vasodilation of the splanchnic circulation...
2017: Digestive Diseases
https://www.readbyqxmd.com/read/28419624/the-effect-of-single-oral-doses-of-duloxetine-reboxetine-and-midodrine-on-the-urethral-pressure-in-healthy-female-subjects-using-urethral-pressure-reflectometry
#4
Niels Klarskov, Dirk Cerneus, William Sawyer, Donald Newgreen, Olivier van Till, Gunnar Lose
AIMS: To evaluate the effect on urethral pressure of reference drugs known to reduce stress urinary incontinence symptoms by different effect size and mechanisms of action on urethral musculature under four test conditions in healthy female subjects using urethral pressure reflectometry. METHODS: Healthy females aged 18-55 years were recruited by advertising for this phase 1, single site, placebo-controlled, randomized, four-period, crossover study. The interventions were single oral doses of 10 mg Midodrine, 80 mg Duloxetine, 12 mg Reboxetine, and placebo...
April 18, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28403995/comparative-efficacy-of-pharmacological-strategies-for-management-of-type-1-hepatorenal-syndrome-a-systematic-review-and-network-meta-analysis
#5
Antonio Facciorusso, Apoorva K Chandar, M Hassan Murad, Larry J Prokop, Nicola Muscatiello, Patrick S Kamath, Siddharth Singh
BACKGROUND: Several drugs have been studied to improve outcomes for patients with hepatorenal syndrome, but trials have reported variable efficacy. We aimed to compare the efficacy of different management strategies for type 1 hepatorenal syndrome. METHODS: For this systematic review and network meta-analysis, we searched Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Scopus, and Web of Science for papers published up to June 9, 2016...
February 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28352627/treatment-of-cirrhosis-associated-hyponatremia-with-midodrine-and-octreotide
#6
Sharad Patel, Dai-Scott Nguyen, Anjay Rastogi, Minh-Kevin Nguyen, Minhtri K Nguyen
BACKGROUND: Hyponatremia in the setting of cirrhosis is a common electrolyte disorder with few therapeutic options. The free water retention is due to non-osmotic vasopressin secretion resulting from the cirrhosis-associated splanchnic vasodilatation. Therefore, vasoconstrictive therapy may correct this electrolyte abnormality. The aim of this study was to assess the efficacy of midodrine and octreotide as a therapeutic approach to increasing urinary electrolyte-free water clearance (EFWC) in the correction of cirrhosis-associated hyponatremia...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28327122/midodrine-as-adjunctive-support-for-treatment-of-refractory-hypotension-in-the-intensive-care-unit-a-multicenter-randomized-placebo-controlled-trial-the-midas-trial
#7
Matthew H Anstey, Bradley Wibrow, Tharusan Thevathasan, Brigit Roberts, Khushi Chhangani, Pauline Yeung Ng, Alexander Levine, Alan DiBiasio, Todd Sarge, Matthias Eikermann
BACKGROUND: Patients admitted to intensive care units (ICU) are often treated with intravenous (IV) vasopressors. Persistent hypotension and dependence on IV vasopressors in otherwise resuscitated patients lead to delay in discharge from ICU. Midodrine is an oral alpha-1 adrenergic agonist approved for treatment of symptomatic orthostatic hypotension. This trial aims to evaluate whether oral administration of midodrine is an effective adjunct to standard therapy to reduce the duration of IV vasopressor treatment, and allow earlier discharge from ICU and hospital...
March 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28195228/ejaculation-and-sperm-characteristics-in-men-with-cauda-equina-and-conus-medullaris-syndromes
#8
N Hadiji, R Mieusset, J G Previnaire, E Castel-Lacanal, J M Soler
STUDY DESIGN: Retrospective. OBJECTIVES: The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality. SETTING: France. METHODS: One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity)...
June 2017: Spinal Cord
https://www.readbyqxmd.com/read/28092986/the-treatment-of-primary-orthostatic-hypotension
#9
Genevieve M Hale, Jose Valdes, Michael Brenner
OBJECTIVE: To review the efficacy and safety of pharmacological and nonpharmacological strategies used to treat primary orthostatic hypotension (OH). DATA SOURCES: A literature review using PubMed and MEDLINE databases searching hypotension, non-pharmacological therapy, midodrine, droxidopa, pyridostigmine, fludrocortisone, atomoxetine, pseudoephedrine, and octreotide was performed. STUDY SELECTION AND DATA EXTRACTION: Randomized or observational studies, cohorts, case series, or case reports written in English between January 1970 and November 2016 that assessed primary OH treatment in adult patients were evaluated...
May 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28052382/systematic-review-with-meta-analysis-vasoactive-drugs-for-the-treatment-of-hepatorenal-syndrome-type-1
#10
REVIEW
F J Gifford, J R Morling, J A Fallowfield
BACKGROUND: Hepatorenal syndrome type 1 (HRS1) is a functional, rapidly progressive, potentially reversible form of acute kidney injury occurring in patients with cirrhosis. Characterised by intense renal arterial vasoconstriction, it carries a very poor prognosis. There is a significant unmet need for a widely approved, safe and effective pharmacological treatment. AIM: To re-evaluate efficacy and safety of pharmacological treatments for HRS1, in the light of recently published randomised controlled trials (RCTs)...
March 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27864240/new-horizons-in-orthostatic-hypotension
#11
James Frith, Steve W Parry
Background: orthostatic hypotension (OH) is a common disabling condition associated with increased morbidity and mortality. Much of the evidence available is derived from younger populations with chronic neurological disease leading to uncertainty for the diagnosis and management of older people. Objective: to provide an overview of recent and emerging evidence for the diagnosis, management and prognosis of OH in older persons. Methods: a narrative review of recent studies, emerging therapies and relevant regulatory updates...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/27662327/prevalence-and-prescribed-treatments-of-orthostatic-hypotension-in-institutionalized-patients-with-parkinson-s-disease
#12
Alaj Hommel, M J Faber, N J Weerkamp, J G van Dijk, B R Bloem, R T Koopmans
BACKGROUND: Orthostatic hypotension (OH) in Parkinson's disease (PD) is a common non-motor sign that can be hard to recognize and treat. OH prevalence and treatment in institutionalized PD-patients remains unknown. OBJECTIVE: The aim of this study was to explore the prevalence and prescribed treatments of OH in institutionalized patients with PD. METHOD: A cross-sectional study of nursing homes in the south-east of the Netherlands identified 64 residents with PD (inclusion criteria: MMSE >18)...
October 19, 2016: Journal of Parkinson's Disease
https://www.readbyqxmd.com/read/27660674/therapeutic-alternatives-for-the-treatment-of-type-1-hepatorenal-syndrome-a-delphi-technique-based-consensus
#13
Juan P Arab, Juan C Claro, Juan P Arancibia, Jorge Contreras, Fernando Gómez, Cristian Muñoz, Leyla Nazal, Eric Roessler, Rodrigo Wolff, Marco Arrese, Carlos Benítez
AIM: To propose several alternatives treatment of type 1 hepatorenal syndrome (HRS-1) what is the most severe expression of circulatory dysfunction on patients with portal hypertension. METHODS: A group of eleven gastroenterologists and nephrologists performed a structured analysis of available literature. Each expert was designated to review and answer a question. They generated draft statements for evaluation by all the experts. Additional input was obtained from medical community...
September 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27652229/the-drug-treatment-of-delayed-ejaculation
#14
REVIEW
Ibrahim A Abdel-Hamid, Moustafa A Elsaied, Taymour Mostafa
Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically .We also highlighted specific settings where drugs could be introduced to medical practice. Electronic databases were searched from 1966 to February 2016, including PubMed MEDLINE, EMBASE, EBCSO Academic Search Complete, Cochrane Systematic Reviews Database, and Google Scholar using key words; delayed ejaculation, retarded ejaculation, inhibited ejaculation, drugs, treatment, or pharmacology...
August 2016: Translational Andrology and Urology
https://www.readbyqxmd.com/read/27639073/a-novel-sensitive-and-selective-method-of-uplc-ms-ms-for-rapid-simultaneous-determination-of-midodrine-and-its-active-metabolite-desglymidodrine-in-human-plasma-application-to-support-bioequivalence-study-in-healthy-human-volunteers
#15
RANDOMIZED CONTROLLED TRIAL
Daxesh P Patel, Sneha Nair, Bhanubhai N Suhagia, Bhargav M Patel
A specific, rapid, sensitive and selective ultra-performance liquid chromatography - tandem mass spectrometry has been developed for the simultaneous determination of midodrine and desglymidodrine in human plasma. The analytes and its deuterated analogs were quantitatively extracted from 100μL of human plasma by solid phase extraction technique. Separation of analytes was achieved on the Waters Acquity UPLC BEH C18 (50×2.1mm, 1.7μm) column using acetonitrile-4.0mM ammonium formate, pH 2.5(90:10, v/v) as mobile phase...
November 30, 2016: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/27622998/rifaximin-and-midodrine-improve-clinical-outcome-in-refractory-ascites-including-renal-function-weight-loss-and-short-term-survival
#16
RANDOMIZED CONTROLLED TRIAL
Amr S Hanafy, Ahmad M Hassaneen
BACKGROUNDS AND AIMS: The occurrence of refractory ascites in nearly 17% of patients with decompensated cirrhosis is an unresolved issue. Advanced liver disease, functional renal impairment, and vascular insensitivity to vasopressors are the main causes of its refractoriness. Therefore, the aim of this study was to evaluate the impact on diuresis, weight loss, and short-term survival if midodrine and rifaximin were added to the diuretic therapy (DT). MATERIALS AND METHODS: The study evaluated the eligibility of 650 patients with cirrhosis and refractory ascites who were selected during the period from November 2011 to May 2015...
December 2016: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27614145/midodrine-and-tolvaptan-in-patients-with-cirrhosis-and-refractory-or-recurrent-ascites-a-randomised-pilot-study
#17
Nitish Rai, Baljinder Singh, Akash Singh, Rajesh Vijayvergiya, Navneet Sharma, Ashish Bhalla, Virendra Singh
BACKGROUND: Splanchnic arterial vasodilatation and subsequent sodium and water retention play an important role in cirrhotic ascites. Midodrine and tolvaptan have been used separately in these patients. However, there are no reports on the use of combination of midodrine and tolvaptan in the control of ascites. The aim of this study was to evaluate the safety and efficacy of midodrine, tolvaptan and their combination in control of refractory or recurrent ascites in cirrhotics. METHODS: Fifty cirrhotic patients with refractory or recurrent ascites were randomised to receive midodrine (n=13), tolvaptan (n=12) or both (n=13) plus standard medical therapy (SMT) or SMT alone (n=12)...
March 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27417951/severe-hypertension-and-bradycardia-secondary-to-midodrine-overdose
#18
L Y Wong, A Wong, T Robertson, K Burns, M Roberts, G K Isbister
The objective of this case is to describe the pharmacokinetics and toxicity of midodrine in overdose. A 20 year old female ingested up to 350 mg midodrine while recovering in hospital from another overdose. She developed vomiting and severe hypertension (blood pressure [BP], 210/100 mmHg). Remarkable findings included a heart rate with a range of 43-60 beats/min, spontaneous respirations (20 breaths/min), and oxygen saturations of >95 % on FiO2 25 %, and a GS of 8. She was admitted to intensive care and had a normal non-contrast CT brain...
March 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/27412743/-predictive-value-of-upright-blood-pressure-change-for-long-term-prognosis-of-children-with-postural-tachycardia-syndrome-treated-with-midodrine-hydrochloride
#19
H X Li, W J Deng, C Y Zhang, H F Jin, J B Du
OBJECTIVE: To explore the predictive value of upright blood pressure change for long-term prognosis of children with postural tachycardia syndrome (POTS) treated with midodrine hydrochloride. METHOD: A total of 90 children (male 41, female 49) were enrolled in this study. Their mean age was (11.8±2.7) years. They were diagnosed as POTS in Peking University First Hospital from 2005 to 2011. According to the upright change of blood pressure at the first visit, they were divided into two groups, effective group (n=55) and ineffective group(n=35)...
July 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27372462/clinical-benefit-of-midodrine-hydrochloride-in-symptomatic-orthostatic-hypotension-a-phase-4-double-blind-placebo-controlled-randomized-tilt-table-study
#20
William Smith, Hong Wan, David Much, Antoine G Robinson, Patrick Martin
OBJECTIVE: Midodrine hydrochloride is a short-acting pressor agent that raises blood pressure in the upright position in patients with orthostatic hypotension. The US Food and Drug Administration's Subpart H approval, under which midodrine was initially approved, requires post-marketing studies to confirm midodrine's clinical benefit in this indication. The purpose of this study was to evaluate the clinical benefit of midodrine with regard to symptom response. METHODS: This was a double-blind, placebo-controlled, randomized, crossover, multicenter study (NCT01518946)...
August 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
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