Nausea orthostatic hypotension

Nausea, orthostatic hypotension, confusion, dyskinesia, hallucinations, peripheral... 

Dopamine precursors are considered first-line in adults. Side effects include orthostatic hypotension, insomnia, daytime fatigue, and somnolence nausea, and augmentation may occur. Levodopa with benserazide or carbidopa (Sinemet) 100-125 mg or 200-250 mg at bedtime and additional doses may be needed. Dopamine agonists are becoming more popular because of the fewer side effects, and less augmentation. These are used to treat RLS and PLMD. Their side effects include nausea, orthostatic hypotension, insomnia, and somnolence also, the potential for tolerance exists. 

Two COMT inhibitors are available for this use, tolcapone (tasmar) and entacapone (comtan). Tolcapone has a relatively long duration of action, allowing for administration two to three times a day, and appears to act by both central and peripheral inhibition of COMT. The duration of action of entacapone is short, around 2 hours, so it usually is administered simultaneously with each dose of levodopa/carbidopa. The action of entacapone is attributable principally to peripheral inhibition of COMT. The common adverse effects of these agents are similar to those observed in patients treated with levodopa/carbidopa alone and include nausea, orthostatic hypotension, vivid dreams, confusion, and hallucinations. An adverse effect associated with tolcapone is hepatotoxicity tolcapone should be used only in patients who have not responded to other therapies and with appropriate monitoring of hepatic transaminases. Entacapone has not been associated with hepatotoxicity and requires no special monitoring. Entacapone also is available in fixed-dose combinations with levodopa/carbidopa (stalevo). 

Adrenal insufficiency is a critical deficiency of the mineralocorticoids and the glucocorticoids that requires immediate treatment. % mptoms of adrenal insufficiency include fever, myalgia, arthralgia, malaise, anorexia, nausea, orthostatic hypotension, dizziness, fainting, dyspnea, and hypoglycemia Deatli due to circulatory coll ise will result unl s tlie condition is treated promptly. Situations producing stress (eg, trauma, surgery, severe illn s) may precipitate tlie need for an increase in dos e of the corticosteroids until the crisis situation or stressful situation is resolved. 

Withdrawal symptoms if drugs stopped abruptly Fever, myalgias, arthralgias, malaise, nausea, orthostatic hypotension, dizziness, fainting, dyspnea, hypoglycemia... 

Adverse reactions of amantadine include gastrointestinal upset with nausea and vomiting, anorexia, asthenia (weakness, loss of strength), constipation, depression, visual disturbances, psychosis, urinary retention, and orthostatic hypotension. 

The most common serious adverse reactions to amantadine are orthostatic hypotension, depression, congestive heart failure, psychosis, urinary retention, convulsions, leukopenia, and neutropenia Less serious reactions include hallucinations, confusion, anxiety, anorexia, nausea, and constipation. Adverse reactions with selegiline include nausea, hallucinations, confusion, depression, loss of balance, and dizziness. 

The adverse reactions most often associated with the administration of the COMT inhibitors include disorientation, confusion, light-headedness, dizziness, dyskinesias, hyperkinesias, nausea, vomiting, hallucinations, and fever. Other adverse reactions are orthostatic hypotension, sleep disorders, excessive dreaming, somnolence, and muscle cramps. A serious and possibly fatal adverse reaction that can occur with the administration of tolcapone is liver failure... 

Inform patients diat orthostatic hypotension may develop witii or witiiout symptoms of dizziness, nausea, fainting, and sweating. Caution die patient against rising rapidly after sitting or lying down. 

Sedation and dry mouth are the most common adverse reactions seen with the use of TCAs. Tolerance to these effects develops with continued use. Orthostatic hypotension can occur with the administration of the TCAs. Orthostatic hypotension is a drop in blood pressure of 20 to 30 points when a person changes position, such as going from a lying position to a standing position. Mental confusion, lethargy, disorientation, rash, nausea, vomiting, constipation, urinary retention, visual disturbances, photosensitivity, and nasal congestion also may be seen. Sexual dysfunction may occur with administration of clomipramine. 

Orthostatic hypotension is a common adverse reaction seen with the administration of the MAOIs. Other common adverse reactions include dizziness, vertigo, nausea, constipation, dry mouth, diarrhea, headache, and overactivity. 

Sedation, anticholinergic effects (dry mouth, dry eyes, urinary retention), nausea, nasal congestion, blurred vision, orthostatic hypotension, lethargy, confusion, constipation, diarrhea... 

Electrolyte imbalances, anorexia, nausea, vomiting, dizziness, rash, photosensitivity reactions, postural or orthostatic hypotension, glycosuria Electrolyte imbalances, anorexia, nausea, vomiting, fever, chills, anxiety, confusion, hematologic changes me as bumetanide... 

Labetalol hydrochloride 20-80 mg IV bolus every 10 minutes 5-10 minutes 3-6 hours Vomiting, scalp tingling, dizziness, bronchoconstriction, nausea, heart block, orthostatic hypotension Most hypertensive emergencies except acute heart failure... 

Common side effects include nausea, vomiting, sedation (highest with apomorphine), pedal edema, orthostatic hypotension (highest with pramipexole and cabergoline), and... 

Side effects include dyskinesias, orthostatic hypotension, dizziness, nausea, insomnia, sleep attacks, pathologic gambling, discoloration of urine/sweat, and psychiatric effects (confusion, hallucinations, nightmares, and altered behavior). Dyskinesias caused by adding other PD drugs to levodopa may be improved by decreasing the levodopa dose. Motor complications occur in about 40% of patients within 4 to 6 years of starting levodopa.1,8,24,25,37... 

Bromocriptine directly binds to the D2 receptors on the lac-totroph cells to exert its effect. Bromocriptine normalizes prolactin level, restores menstrual cycles, and reduces tumor size in approximately 90% of patients.49 Adverse effects such as nausea, dizziness, and orthostatic hypotension often limit 5% to 10% of patients from continuing treatment. Thus, start bromocriptine at a low dose (e.g., 0.625-1.25 mg) at bedtime... 

Bromocriptine (Parlodel ) 0.625-1.25 mg/day at bedtime 1.25 mg increments at 1 -week interval 2.5-1 5 mg/day 40 mg/day 2 to 3 divided doses per day Dizziness, headache, syncope, nausea, vomiting, Gl cramps, orthostatic hypotension ... 

IV infusion dizziness, nausea, heart block, orthostatic hypotension... 

Common side effects of the SSRIs are somnolence, nausea, ejaculation disorders, decreased libido, dry mouth, insomnia, and fatigue. Tricyclic antidepressants (TCAs) commonly cause sedation, orthostatic hypotension, anticholinergic effects, and weight gain. TCAs are very toxic on overdose. 

Adverse reactions associated with loop diuretics include nausea vomiting diarrhea gastric irritation headache fatigue dizziness thrombocytopenia rash orthostatic hypotension hyperuricemia hyperglycemia electrolyte imbalance (decreased chloride, potassium and sodium) dehydration. 

Adverse reactions occurring in 3% or more of patients include nausea, dizziness, lightheadedness, fainting, abdominal pain, confusion, hallucinations, depression, loss of balance, insomnia, orthostatic hypotension, increased akinetic involuntary movements, agitation, arrhythmias, bradykinesia, chorea, delusions, hypertension, new or increased angina pectoris, syncope, and dry mouth. 

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