Abstract | OBJECTIVE: To determine the mean arterial pressure (MAP) and middle cerebral artery mean blood flow velocity (MFV) responses to 5 and 10mg midodrine during head-up tilt (HUT) in persons with tetraplegia. DESIGN: Prospective dose-response trial. SETTING: James J. Peters Veterans Administration Medical Center. PARTICIPANTS: Persons (N=10) with chronic tetraplegia (duration of injury=23+/-11 y). INTERVENTION: A dose titration study was performed over 3 testing days: control (no drug), 5mg midodrine (5mg), or 10mg midodrine (10mg) during 30 minutes of baseline (predrug/no drug), 30 minutes of supine rest postdrug/no drug, 15 minutes of progressive HUT (5 minutes at 15 degrees , 25 degrees , 35 degrees ), and 45 minutes of 45 degrees HUT. MAIN OUTCOME MEASURES: MAP and MFV response to midodrine supine and during HUT. RESULTS: Ten milligrams of midodrine significantly increased MAP while supine and during the HUT maneuver. Of note, the mean increase in MAP during HUT with 10mg was a result of a robust effect in 2 persons, with minimal change in the remaining 8 study subjects. The reduction in cerebral MFV during HUT was attenuated with 10mg. CONCLUSIONS:
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Authors | Jill M Wecht, Dwindally Rosado-Rivera, John P Handrakis, Miroslav Radulovic, William A Bauman |
Journal | Archives of physical medicine and rehabilitation
(Arch Phys Med Rehabil)
Vol. 91
Issue 9
Pg. 1429-35
(Sep 2010)
ISSN: 1532-821X [Electronic] United States |
PMID | 20801263
(Publication Type: Clinical Trial, Journal Article, Research Support, U.S. Gov't, Non-P.H.S.)
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Chemical References |
- Vasoconstrictor Agents
- Midodrine
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Topics |
- Adult
- Cerebrovascular Circulation
(drug effects)
- Dose-Response Relationship, Drug
- Female
- Humans
- Hypotension
(drug therapy, etiology)
- Hypotension, Orthostatic
(drug therapy, etiology)
- Male
- Middle Aged
- Midodrine
(pharmacology, therapeutic use)
- Quadriplegia
(complications, rehabilitation)
- Spinal Cord Injuries
(complications, rehabilitation)
- Tilt-Table Test
- Vasoconstrictor Agents
(pharmacology, therapeutic use)
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