Standing Positions

Help seated patients to a standing position and instruct them to stand in one place for about 1 minute before ambulating. 

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. 

With orthostatic hypotension, the nurse instructs the patient to rise from a lying position to a sitting position. The patient remains in a sitting position for a few minutes before rising to a standing position. Position changes... 

VF results in immediate loss of pulse and blood pressure. Patients who are in the standing position at the onset of VF suddenly immediately collapse to the ground. 

Hydralazine is equally effective in the supine and standing positions. The cardiovascular reflexes are intact and no postural hypotension is seen. However, the reflex tachycardia and increase in cardiac output (Figure 1) severely limit the clinical use of this drug. Tachycardia is almost invariably associated with the subjective complaints of severe palpitations (Figure 1). 

The blood pressure reduction by the diuretic agents occurs equally in supine, sitting and standing positions, at rest and during exercise. There is no orthostatic hypotension(13,14). 

Place the potato chip in an evaporating dish on the metal base of the ring stand. Position the ring and wire gauze so that they will be 10 cm above the top of the potato chip. 

Despite the Commission s long-standing position, the scientific community has continued to use source-based nomenclature for homopolymers such as polystyrene and poly(vinyl acetate) because of their simplicity, convenience and obvious relationship with the monomers from which the homopolymers are prepared. The Commission therefore decided to recommend source-based nomenclature as an alternative official nomenclature for homopolymers in a 2001 publication [2]. Consequently, both source-based and structure-based names are now available for most polymers. The names of monomers in the source-based names may be traditional or semi-systematic, if well established by usage, and not necessarily only those retained in the 1993 A Guide to lUPAC Nomenclature of Organic Compounds [3]. 

Rise slowly to sitting/standing position to minimize orthostatic hypotension... 

Maintenance doses should be limited to dose that causes slight faintness or dizziness in the standing position... 

Therapeutic uses Thiazide diuretics decrease blood pressure in both the supine and standing positions postural hypotension is rarely observed, except in elderly, volume-depleted patients. These agents counteract the sodium and water retention observed with other agents used in the treatment of hypertension (for example, hydralazine). Thiazides are therefore useful in combination therapy with a variety of other antihypertensive agents including (3-blockers and ACE inhibitors. Thiazide diuretics are particularly useful in the treatment of black or elderly patients, and in those with chronic renal disease. Thiazide diuretics are not effective in patients with inadequate kidney function (creatinine clearance less than 50 mls/min). Loop diuretics may be required in these patients. 

Diazepam As mentioned earlier, because of shortcomings of rectal administration, the nasal delivery of diazepam has gained interest. The nasal bioavailability of diazepam in sheep was estimated and further compared with results obtained earlier in humans and rabbits [106] in this study, human and rabbit nasal bioavailability for the first 30min was reported to be 37 and 54%, respectively [113]. Diazepam solubilized in PEG 300 was used for nasal administration via a modified nasal device, a Pfeiffer unit dose (Princeton, NJ). The sheep received the nasal formulations in a fixed standing position such that the head was slightly tilted back. It was found that the serum concentration after administration of a 7-mg solution of diazepam was... 

Gessner, M. O. (2001). Mass loss, fungal colonisation and nutrient dynamics of Phragmites australis leaves during senescence and early decay in a standing position. Aquatic Botany, 69, 325-39. 

Hagan, R.D., Diaz, F.J. Horvath, S.M. changes with movement to supine and standing positions. J. 

Nausea, usually mild and not associated with vomiting, has been reported after oral doses of ropinirole, in both supine and standing positions (1-5). Nausea is related to peripheral dopaminergic activity and has been controlled by pretreatment with domperidone (20 mg) (2,3). In one study in healthy subjects, nausea was not reported in the supine position after oral ropinirole however, nausea with malaise was common on standing (orthostatic symptoms) (2). 

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