Pharmacokinetic and pharmacodynamic effects of midodrine on blood pressure, the autonomic nervous system, and plasma natriuretic peptides: a prospective, randomized, single-blind, two-period, crossover, placebo-controlled study

• Published in: Clinical therapeutics Vol. 30; no. 9; pp. 1629 - 1638
• Main Authors: Lamarre-Cliche, Maxime, Souich, Patrick du, Champlain, Jacques de, Larochelle, Pierre
• Format: Journal Article
• Language: English
• Published: Belle Mead, NJ EM Inc USA 01.09.2008; Excerpta Medica; Elsevier Limited
• Subjects: Adult; Autonomic Nervous System - drug effects; Biological and medical sciences; Blood Pressure - drug effects; Catecholamines; Chromatography, High Pressure Liquid; Cross-Over Studies; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Dopamine; Drug dosages; drug therapy; Fainting; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Heart attacks; Heart rate; Heart Rate - drug effects; Humans; Hypertension; Hypotension, Orthostatic - drug therapy; Internal Medicine; Male; Medical Education; Medical sciences; Menstruation; midodrine; Midodrine - administration & dosage; Midodrine - pharmacokinetics; Midodrine - pharmacology; Midodrine - therapeutic use; Natriuretic Peptides - blood; Natriuretic Peptides - pharmacology; Natriuretic Peptides - therapeutic use; Nervous system; Nervous system (semeiology, syndromes); neurocardiogenic syncope; Neurology; Norepinephrine - blood; Orthostatic hypotension; Peptides; Pharmacokinetics; Pharmacology. Drug treatments; Plasma; Prospective Studies; Single-Blind Method; Sympathomimetics - administration & dosage; Sympathomimetics - pharmacokinetics; Sympathomimetics - pharmacology; Sympathomimetics - therapeutic use; Syncope, Vasovagal - drug therapy; Canada; Quebec Canada; orthostatic hypotension; drug therapy; neurocardiogenic syncope; midodrine; Biological fluid; Pharmacokinetic pharmacodynamic relationship; Agonist; Vasodilator agent; Pharmacotherapy; Cardiovascular disease; Atrial natriuretic peptide; Blood plasma; Prospective; Postural hypotension; Randomization; Natriuretic hormone; Syncope; Autonomic nervous system; Arterial pressure; Blood pressure; Neurological disorder; Nervous system diseases; Consciousness impairment; Sympathomimetic; Midodrine; Crossover study; Treatment; Arterial hypotension; Diseases of the autonomic nervous system; Placebo; Antihypertensive agent; Hemodynamics

Background: Midodrine is an α-agonist prodrug of desglymidodrine (DGM) that has been reported to be of clinical benefit in patients with neurocardiogenic syncope. Its effects may be mediated not only by its hypertensive properties but also by its neurohumoral influences independent of blood pressure...