Wednesday, December 10, 2008

Day Twelve

Always know the medication that you are administering!
Orthostatic hypotension:
Treatment of symptomatic orthostatic hypotension. Because midodrine can cause marked elevation of supine blood pressure (BP greater than 200 mmHg systolic), it should be used in patients whose lives are considerably impaired despite standard clinical care, including nonpharmacological treatment (such as support stockings), fluid expansion, and lifestyle alterations. The indication is based on midodrine's effect on increases in 1-minute standing systolic blood pressure, a surrogate marker considered likely to correspond to a clinical benefit. At present however, clinical benefits of midodrine principally improved ability to perform life activities have not been established. Further clinical trials are underway to verify and describe the clinical benefits of midodrine. After initiation of treatment, midodrine should be continued only for patients who report significant symptomatic improvement.