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Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines

Spinal cord injury is a devastating chronic condition resulting in temporary or permanent motor, sensory or autonomic dysfunction of the cord. The manifestation of spinal cord injury based on the severity and involved areas could be different. Numerous studies have demonstrated that bradycardia, hyp...

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Autores principales: Mojtahedzadeh, Mojtaba, Taghvaye-masoumi, Hamidreza, Najafi, Atabak, Dianatkhah, Mehrnoush, Sharifnia, Hamidreza, Shahrokhi, Maryam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Shaheed Beheshti University of Medical Sciences 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059064/
https://www.ncbi.nlm.nih.gov/pubmed/32184877
http://dx.doi.org/10.22037/ijpr.2019.1100824
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author Mojtahedzadeh, Mojtaba
Taghvaye-masoumi, Hamidreza
Najafi, Atabak
Dianatkhah, Mehrnoush
Sharifnia, Hamidreza
Shahrokhi, Maryam
author_facet Mojtahedzadeh, Mojtaba
Taghvaye-masoumi, Hamidreza
Najafi, Atabak
Dianatkhah, Mehrnoush
Sharifnia, Hamidreza
Shahrokhi, Maryam
author_sort Mojtahedzadeh, Mojtaba
collection PubMed
description Spinal cord injury is a devastating chronic condition resulting in temporary or permanent motor, sensory or autonomic dysfunction of the cord. The manifestation of spinal cord injury based on the severity and involved areas could be different. Numerous studies have demonstrated that bradycardia, hypotension, and orthostatic hypotension are present insignificant number of patients after spinal cord injury which peaks at 4(th) day of injury. Although vasopressors are common drugs that have been used to restore blood pressure and heart rate in patients with neurogenic shock, there is limited data regarding pharmacologic management of bradycardia and hypotension after spinal cord injury. Midodrine is a potent vasopressor approved for the management of symptomatic orthostatic hypotension. Theophylline and aminophylline are methylxanthine derivatives. There are very few case reports concerning the use of midodrine and methylxanthines for treatment of hypotension in patients with spinal cord injury. In this case report and review of the articles we report a 45 year old woman with a diagnosis of spinal cord injury who was successfully managed with midodrine and aminophylline and then we review current case reports. Based on our case report and other available data, midodrine as well as methylxanthines can be suggested as therapeutic options for managing symptoms in spinal cord injury patients.
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spelling pubmed-70590642020-03-17 Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines Mojtahedzadeh, Mojtaba Taghvaye-masoumi, Hamidreza Najafi, Atabak Dianatkhah, Mehrnoush Sharifnia, Hamidreza Shahrokhi, Maryam Iran J Pharm Res Case Report Spinal cord injury is a devastating chronic condition resulting in temporary or permanent motor, sensory or autonomic dysfunction of the cord. The manifestation of spinal cord injury based on the severity and involved areas could be different. Numerous studies have demonstrated that bradycardia, hypotension, and orthostatic hypotension are present insignificant number of patients after spinal cord injury which peaks at 4(th) day of injury. Although vasopressors are common drugs that have been used to restore blood pressure and heart rate in patients with neurogenic shock, there is limited data regarding pharmacologic management of bradycardia and hypotension after spinal cord injury. Midodrine is a potent vasopressor approved for the management of symptomatic orthostatic hypotension. Theophylline and aminophylline are methylxanthine derivatives. There are very few case reports concerning the use of midodrine and methylxanthines for treatment of hypotension in patients with spinal cord injury. In this case report and review of the articles we report a 45 year old woman with a diagnosis of spinal cord injury who was successfully managed with midodrine and aminophylline and then we review current case reports. Based on our case report and other available data, midodrine as well as methylxanthines can be suggested as therapeutic options for managing symptoms in spinal cord injury patients. Shaheed Beheshti University of Medical Sciences 2019 /pmc/articles/PMC7059064/ /pubmed/32184877 http://dx.doi.org/10.22037/ijpr.2019.1100824 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Mojtahedzadeh, Mojtaba
Taghvaye-masoumi, Hamidreza
Najafi, Atabak
Dianatkhah, Mehrnoush
Sharifnia, Hamidreza
Shahrokhi, Maryam
Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
title Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
title_full Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
title_fullStr Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
title_full_unstemmed Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
title_short Management of Hypotension and Bradycardia Caused By Spinal Cord Injury. The Usefulness of Midodrine and Methylxanthines
title_sort management of hypotension and bradycardia caused by spinal cord injury. the usefulness of midodrine and methylxanthines
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059064/
https://www.ncbi.nlm.nih.gov/pubmed/32184877
http://dx.doi.org/10.22037/ijpr.2019.1100824
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