Midodrine

In patients taking midodrine for orthostatic hypotension, the nurse checks the blood pressure with the patient supine and sitting before therapy is begun. This is important because midodrine is contraindicated in patients with supine hypertension. 

CARING FOR THE PATIENT TAKING MIDODRINE This drug is administered only when the paHent is out of bed. Bedridden patients should not receive Hie drug. The paHent taking midodrine will need frequent moni-... 

Supine hypertension isa potentially dangerous adverse reaction when taking midodrine. The nurse can minimize this reaction by administering the medication during the day while the patient is in an upright position. Keeping the patient in an upright position can sometimes control supine hypertension. This requires that the patient sleep with the head of the bed elevated. 

The following isa suggested dosing schedule for the administration of midodrine shortly before arising in the morning, midday, and late afternoon (not after 6 00 fm). The nurse should continue drug therapy only in the patient whose orthostatic hypotension improves during the initial treatment. 

EDUCATING THE PATIENT PRESCRIBED MIDODRINE When midodrine is given to patients with severe orthostatic hypotension, tiie nurse explains the importance of... 

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Preventive measures for patients who may be prone to hypotension include accurate determination of the dry weight and maintaining a constant ultrafiltration rate. Midodrine is an a-adrenergic agonist that is effective in reducing hypotension in patients with autonomic dysfunction that is taken with each dialysis session or as chronic therapy. Midodrine can be administered at doses of 2.5 to 10 mg prior to HD or 5 mg twice daily for chronic hypotension. Side effects of midodrine include pruritus and paresthesias. 

Symptomatic carotid sinus hypersensitivity also should be treated with permanent pacemaker therapy. Patients who remain symptomatic may benefit from adding an a-adrenergic stimulant such as midodrine. 

Drugs fludrocortisone, NSAIDs, midodrine, pyridostigmine, caffeine... 

M. Tsuda, T. Terada, M. Irie, T. Katsura, A. Niida, K. Tomita, N. Fujii, and K. Inui. Transport characteristics of a novel peptide transporter 1 substrate, antihypotensive drug midodrine, and its amino acid derivatives. J Pharmacol Exp Ther 318 455-460 (2006). 

H. Pittner, H. Stormann, R. Enzenhofer, Pharmacodynamic Actions of Midodrine, a New a-Adrenergic Stimulating Agent, and Its Main Metabolite, ST 1059 , Arzneim.-Forsch. 1976, 26, 2145 - 2154. 

Midodrine (ProAmatine) Pressor Tab 2.5,5 mg Initially 2.5 mg tid, titrate to 10 mg tid. Paresthesia, piloerection, urinary retentbn used for orthostatic hypotension. 

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