Details About Generic Salt ::  Midodrin

Main Medicine Class:: Vassopressor,antihypotensive agent   

(mid-OH-drean HIGH-droe-KLOR-ide)
ProAmatine
Class: Vassopressor/antihypotensive agent

 

Drugs Class ::

 Action Activates arteriolar and venous a-adrenergic receptors resulting in an increase in vascular tone and elevation of blood pressure.

Indications for Drugs ::

 Indications Treatment of symptomatic orthostatic hypotension in patients whose lives are considerably impaired despite standard clinical care, including support stockings, fluid expansion and lifestyle changes. Unlabeled use(s): Management of urinary incontinence.

Drug Dose ::

 Route/Dosage

ADULTS: PO 10 mg tid during daytime hrs. Renal function impairment: Start with 2.5 mg/dose.

Contraindication ::

 Contraindications Severe organic heart disease, acute renal failure, urinary retention, phenochromocytoma, thyrotoxicosis or in patients with persistent and excessive supine hypertension.

Drug Precautions ::

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Supine hypertension: Potentially most serious adverse reaction. Most common in patients with elevated pre-treatment supine systolic blood pressure (mean 170 mm/hg). Use is not recommended in patients with pre-treatment supine systolic blood pressure >180 mm/hg. Monitor supine and sitting blood pressures. Bradycardia: May occur due to vagal reflex. Use caution when coadministering with other agents that can reduce heart rate (eg, cardiac glycosides, b-blockers, psychopharmacologic agents). Urinary retention: Use with caution due to effect on a-adrenergic receptors of bladder neck. Renal function impairment: Use with caution. Initiate therapy with smaller doses. Hepatic function impairment: Use with caution. Diabetes: Use with caution.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CV: Supine and sitting hypertension; bradycardia. CNS: Paresthesia; headache; confusion; nervousness; anxiety; confusion; abnormal thinking. DERM: Piloerection; scalp pruritis; rash. GI: Abdominal pain; dry mouth. GU: Dysuria (frequency, impaired micturation, urinary retention, urinary urgency). OTHER: Pain; chills; facial flushing; feeling of fullness/pressure in head.

Drug Mode of Action ::  

 Action Activates arteriolar and venous a-adrenergic receptors resulting in an increase in vascular tone and elevation of blood pressure.

Drug Interactions ::

 Interactions

Vasoconstrictors (eg, dihydroergotamine, ephedrine, phenylephrine, phenylpropanolamine, pseudoephedrine): May enhance pressor effects of midodrine. Alpha-blocking agents (eg, prazosin, terazosin, doxazosin): May antagonize pressor effects of midodrine. Cardiac glycosides: May precipitate bradycardia, AV block or arrhythmia. Fludrocortisone: May exacerbate supine hypertension.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history, including drug history and any known allergies. Note hepatic or renal impairment.
  • Obtain necessary lab tests (eg, renal, liver) before initiating therapy.
  • Monitor supine, sitting and standing blood pressure and pulse frequently during initiation of therapy.
  • If supine hypertension noted, have patient sleep with head of bed elevated.
  • If supine blood pressure noted to be > 180 mm/hg, withhold therapy and notify physician.
OVERDOSAGE: SIGNS & SYMPTOMS
  Hypertension, piloerection, sensation of coldness, urinary retention.

Drug Storage/Management ::

 Administration/Storage

  • May be taken without regard to meal except evening dose.
  • Dosing should be q 4 hrs during daylight hours while patient is upright. Administer first dose shortly before or upon arising, second dose at midday and third dose in late afternoon (no later than 6 pm).
  • Doses may be given in 3 hour intervals, if required, to control symptoms, but not more frequently.
  • Do not administer after evening meal or < 4 hrs before bedtime.
  • Store at room temperature.

Drug Notes ::

 Patient/Family Education

  • Ensure that patient understands dosing schedule. Caution patient not to take dose after dinner or < 4 hours before bedtime.
  • Medication can be taken without regard to meal except evening dose.
  • Advise patient not to change the dose, dosing schedule or discontinue the medication without consulting with their physician.
  • Ensure that patient has, and can use, a home blood pressure monitoring device. Advise patient to monitor blood pressure and pulse at regular intervals and notify physician if hypertension or bradycardia noted.
  • Advise patient to elevate head of bed if supine hypertension noted.
  • Educate patient regarding signs and symptoms of supine hypertension eg, cardiac awareness, pounding in ears, headache, blurred vision). Advise patient to discontinue medication and notify physician if noted.
  • Caution patient to consult with their physician or pharmacist before taking other drugs, including otc medications.
  • Advise female patients to notify their physician if they become pregnant or intend to become pregnant or are breastfeeding while taking this drug.
  • Instruct patient to report the following symptoms: numbness or tingling; goosebumps; chills; flushing; feeling of fullness/pressure in head; eadache; confusion; nervousness; urinary problems.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.

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