Pharmacology of orthostatic hypotension in Parkinson's disease: from pathophysiology to management.
Identifieur interne : 000E99 ( PubMed/Checkpoint ); précédent : 000E98; suivant : 000F00Pharmacology of orthostatic hypotension in Parkinson's disease: from pathophysiology to management.
Auteurs : Atul Pathak [France] ; Jean-Michel SenardSource :
- Expert review of cardiovascular therapy [ 1477-9072 ] ; 2004.
English descriptors
- KwdEn :
- Antiparkinson Agents (adverse effects), Autonomic Nervous System Diseases (drug therapy), Autonomic Nervous System Diseases (epidemiology), Autonomic Nervous System Diseases (physiopathology), Blood Volume (drug effects), Efferent Pathways (drug effects), Efferent Pathways (physiopathology), Humans, Hypotension, Orthostatic (chemically induced), Hypotension, Orthostatic (drug therapy), Hypotension, Orthostatic (epidemiology), Hypotension, Orthostatic (physiopathology), Parkinson Disease (drug therapy), Parkinson Disease (epidemiology), Parkinson Disease (physiopathology), Postprandial Period (drug effects), Vasoconstrictor Agents (therapeutic use).
- MESH :
- chemical , adverse effects : Antiparkinson Agents.
- chemically induced : Hypotension, Orthostatic.
- drug effects : Blood Volume, Efferent Pathways, Postprandial Period.
- drug therapy : Autonomic Nervous System Diseases, Hypotension, Orthostatic, Parkinson Disease.
- epidemiology : Autonomic Nervous System Diseases, Hypotension, Orthostatic, Parkinson Disease.
- physiopathology : Autonomic Nervous System Diseases, Efferent Pathways, Hypotension, Orthostatic, Parkinson Disease.
- chemical , therapeutic use : Vasoconstrictor Agents.
- Humans.
Abstract
Orthostatic hypotension is highly prevalent in the elderly, and affects up to 20% of patients with Parkinson's disease. Pharmacological approaches help to demonstrate that Parkinson's disease is a primary autonomic failure with involvement of the peripheral autonomic nervous system as shown by decreased [(123)I] meta-iodobenzylguanidine cardiac uptake and preserved growth hormone response to clonidine. No specific clinical trial has evaluated efficacy of antihypotensive drugs in Parkinson's disease. End point of treatment should be a reduction in postural symptoms. Midodrine (Proamatin), Roberts Pharmaceutical), a vasoconstrictor and fludrocortisone (Florinef), Bristol-Myers Squibb), a volume expander are first choice drugs. No data are available on their effects on orthostatic hypotension-related morbidity. The usefulness of other drugs remains to be demonstrated. This review will highlight the importance of nonpharmacological measures in the management of orthostatic hypotension in Parkinson's disease.
DOI: 10.1586/14779072.2.3.393
PubMed: 15151485
Affiliations:
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pubmed:15151485Le document en format XML
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<term>Hypotension, Orthostatic (drug therapy)</term>
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<front><div type="abstract" xml:lang="en">Orthostatic hypotension is highly prevalent in the elderly, and affects up to 20% of patients with Parkinson's disease. Pharmacological approaches help to demonstrate that Parkinson's disease is a primary autonomic failure with involvement of the peripheral autonomic nervous system as shown by decreased [(123)I] meta-iodobenzylguanidine cardiac uptake and preserved growth hormone response to clonidine. No specific clinical trial has evaluated efficacy of antihypotensive drugs in Parkinson's disease. End point of treatment should be a reduction in postural symptoms. Midodrine (Proamatin), Roberts Pharmaceutical), a vasoconstrictor and fludrocortisone (Florinef), Bristol-Myers Squibb), a volume expander are first choice drugs. No data are available on their effects on orthostatic hypotension-related morbidity. The usefulness of other drugs remains to be demonstrated. This review will highlight the importance of nonpharmacological measures in the management of orthostatic hypotension in Parkinson's disease.</div>
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<Abstract><AbstractText>Orthostatic hypotension is highly prevalent in the elderly, and affects up to 20% of patients with Parkinson's disease. Pharmacological approaches help to demonstrate that Parkinson's disease is a primary autonomic failure with involvement of the peripheral autonomic nervous system as shown by decreased [(123)I] meta-iodobenzylguanidine cardiac uptake and preserved growth hormone response to clonidine. No specific clinical trial has evaluated efficacy of antihypotensive drugs in Parkinson's disease. End point of treatment should be a reduction in postural symptoms. Midodrine (Proamatin), Roberts Pharmaceutical), a vasoconstrictor and fludrocortisone (Florinef), Bristol-Myers Squibb), a volume expander are first choice drugs. No data are available on their effects on orthostatic hypotension-related morbidity. The usefulness of other drugs remains to be demonstrated. This review will highlight the importance of nonpharmacological measures in the management of orthostatic hypotension in Parkinson's disease.</AbstractText>
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