PMID: 11605821Oct 19, 2001Paper

The cardiovascular effects of metoclopramide in multiple system atrophy and pure autonomic failure

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
F MagnificoP Cortelli

Abstract

Metoclopramide (MCP), a central and peripheral dopaminergic blocker with cholinergic activity, has been proposed to treat orthostatic hypotension (OH) on the basis that it could antagonize the vasodilator and natriuretic effects of dopamine. The authors evaluated cardiovascular responses to MCP in 11 subjects with OH: 6 with multiple system atrophy (MSA) and 5 with pure autonomic failure (PAF), along with 6 healthy control subjects. Supine blood pressure (BP), heart rate (HR), and breathing were continuously monitored before, during, and after MCP infusion. The pre-MCP head-up tilt test was tolerated at 65 degrees for 10 minutes in all subjects except in one with PAF, who tolerated 30 degrees for only 5 minutes. Tilting confirmed the OH in patients with MSA (change in mean arterial pressure [deltaMAP] = -31 +/- 13 mm Hg) and PAF (AMAP = -34 +/- 8 mm Hg). Infusion of MCP was given in four 5-mg doses every 5 minutes, with the subject in a supine position. Infusion of MCP induced the following effects: (1) A transient hypotensive effect occurred after each infusion in both patients and control subjects, the fall in MAP being counteracted by an increase in HR in control subjects but not in patients; this acute MAP fall was mo resev...Continue Reading

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Citations

Jul 17, 2013·Drugs·Christoph SchroederHoracio Kaufmann
Dec 17, 2002·Current Opinion in Pharmacology·Olaf OldenburgMichael V Cohen
Jul 9, 2016·Internal Medicine Journal·Peter Chisholm, Mahesan Anpalahan
Aug 8, 2017·Movement Disorders : Official Journal of the Movement Disorder Society·Ana Castro CaldasUNKNOWN Movement Disorders Society MSA Study Group
Nov 15, 2005·Journal of Neural Transmission·C ColosimoG K Wenning
Mar 7, 2018·Movement Disorders : Official Journal of the Movement Disorder Society·Jose-Alberto Palma, Horacio Kaufmann

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