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Orthostatic Sodium Retention

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1. Canadian Cardiovascular Society Position Statement on Postural Orthostatic Tachycardia Syndrome (POTS) and Related Disorders of Chronic Orthostatic Intolerance Full Text available with Trip Pro

than the orthostatic symptoms ( ). Table 3 Noncardiovascular debilitating symptoms • Gastric emptying problems (too fast or too slow) that can present with intractable nausea and sometimes cycling vomiting • Severe constipation and diarrhea • Neurogenic bladder/incontinence/urinary retention • Severe chronic pain • Joint hypermobility • Intractable headaches • Significant flushing/anaphylaxis symptoms • Severe food intolerances • Neurological symptoms (eg, paresthesia, numbness, and neuropathic (...) of autonomic neuropathy, then a more extensive evaluation by an autonomic specialist might be required. Detailed autonomic testing (including tilt table test, plasma norepinephrine levels determination during orthostatic stress, Valsalva manoeuvre, deep breathing test, thermoregulatory sweat test, and quantitative sudomotor axonal reflex test), 24-hour urine sodium, blood volume measurement, and antinicotinic ganglionic antibodies should be considered only in those specific cases. Most patients with POTS

2020 Canadian Cardiovascular Society

2. Orthostatic Sodium Retention

Orthostatic Sodium Retention Orthostatic Sodium Retention Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Orthostatic Sodium Retention (...) Orthostatic Sodium Retention Aka: Orthostatic Sodium Retention , Orthostatic Edema From Related Chapters II. Pathophysiology Abnormal protein capillary leak Provoked by upright position III. Signs Progressive lower extremity with standing Decreased after prolonged standing Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Orthostatic Sodium Retention." Click on the image (or right click) to open the source website in a new browser window

2018 FP Notebook

3. Salt + Glycerol-Induced Hyperhydration Enhances Fluid Retention More Than Salt- or Glycerol-Induced Hyperhydration. (Abstract)

Salt + Glycerol-Induced Hyperhydration Enhances Fluid Retention More Than Salt- or Glycerol-Induced Hyperhydration. Hyperhydration has been demonstrated to improve work capacity and cardiovascular and thermoregulatory functions, enhance orthostatic tolerance, slow or neutralize bone demineralization, and decrease postdive bubble formation. Adding sodium or glycerol to a hyperhydration solution optimizes fluid retention. Sodium and glycerol produce their effect through different (...) physiological mechanisms. If combined into a hyperhydration solution, their impact on fluid retention could potentially be greater than their singular effect. We compared the effect of salt-induced hyperhydration (SIH), glycerol-induced hyperhydration (GIH), and salt + glycerol-induced hyperhydration (SGIH) on fluid balance responses during a 3-hr passive experiment. Using a randomized, crossover, and counterbalanced experiment, 15 young men (22 ± 4 years) underwent three, 3-hr hyperhydration experiments

2018 International journal of sport nutrition and exercise metabolism Controlled trial quality: uncertain

4. Orthostatic hypotension due to autonomic dysfunction: midodrine

, occurring in more than 1 in 10 people. Adverse effects occurring in between 1 in 10 and 1 in 100 people include paraesthesia, headache, nausea, dyspepsia, stomatitis, pruritus, rash, chills, flushing, urinary retention and supine hypertension. Orthostatic hypotension due to autonomic dysfunction: midodrine (ESNM61) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 29P Patient factors atient factors No published (...) the autonomic nervous system (for example, Parkinson's disease, multiple system atrophy or diabetic autonomic neuropathy), from a loss of blood volume or dehydration, or because of certain medications such as antihypertensive drugs. The European Federation of Neurological Societies recommends individually tailored therapy for orthostatic hypertension. Non-pharmacological management options are recommended first-line (including compression stockings, blood pressure monitoring and increased water and salt

2015 National Institute for Health and Clinical Excellence - Advice

5. Orthostatic Sodium Retention

Orthostatic Sodium Retention Orthostatic Sodium Retention Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Orthostatic Sodium Retention (...) Orthostatic Sodium Retention Aka: Orthostatic Sodium Retention , Orthostatic Edema From Related Chapters II. Pathophysiology Abnormal protein capillary leak Provoked by upright position III. Signs Progressive lower extremity with standing Decreased after prolonged standing Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Orthostatic Sodium Retention." Click on the image (or right click) to open the source website in a new browser window

2015 FP Notebook

6. Orthostatic Hypotension Management

severe OH. Table 2: Select Drugs For Treatment Of Orthostatic Hypotension DRUG DOSE/ MOA/ PHARMACOKINETICS ADVANTAGES/ DISADVANTAGES CONTRAINDICATIONS (CI)/ ADVERSE EFFECTS (AE)/ DRUG INTERACTIONS (DI)/ MONITOR (M) Fludrocortisone FLORINEF 0.1mg ? tablets Dose: 0.1 to 0.3mg daily. ?dose weekly or until pedal edema (if start low: 0.05mg) Maximum: 1mg/ day MOA: Synthetic mineralocorticoid (sodium & water retention) Adv: Considered first line therapy after failure of non-pharmacological measures DI (...) failure CNS=central nervous system CV=cardiovascular DHP=dihydropyridine DM=diabetes mellitus e.g.=example GI=gastrointestinal HA=headache HF=heart failure HTN=hypertension hr=hour HR=heart rate HSR=hypersensitivity hx= history i.e.=that is IM= intramuscular IR=immediate release ISA=intrinsic sympathomimetic activity IV=intravenous K + =potassium LA= long acting Na + =sodium nOH=neurogenic orthostatic hypotension NT=neurotransmitter MAOI=monoamine oxidase inhibitors MI=myocardial infraction mins

2014 RxFiles

7. Orthostatic Hypotension

on inspiration on expiration Abnormal if <9 beat/min difference during cycle X. Evaluation See Consider intravascular volume replacement (IV Fluids) Consider causes above (including medications) XI. Complications Orthostatic Syncope XII. Management Avoid medications related to Orthostasis See Decrease dose or change medication to one less likey to cause Orthostatic Hypotension Consider stopping s, s Modify diet Increase salt Indicated for 24 hour urinary <170 mmol in 24 hours Supplement up to 1-2 grams extra (...) Orthostatic Hypotension Orthostatic Hypotension Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Orthostatic Hypotension Orthostatic

2018 FP Notebook

8. What is the recommended dose of fludrocortisone when treating postural orthostatic hypotension.

(100 - 200 mcg at night). This drug causes a retention of salt and water and may also result in an increased adrenoreceptor sensitivity.” 1. Lahrmann H, Cortelli P, Hilz M, Mathias CJ, Struhal W, Tassinari M. Orthostatic hypotension. In: Gilhus NE, Barnes MP, Brainin M, editor(s). European handbook of neurological management. 2nd ed. Vol. 1. Oxford (UK): Wiley-Blackwell; 2011. p. 469-75. [53 references] 2. GP notebook, Drug treatment in postural hypotension, Answered 26 November 2012 Follow us: © (...) What is the recommended dose of fludrocortisone when treating postural orthostatic hypotension. What is the recommended dose of fludrocortisone when treating postural orthostatic hypotension. - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine

2012 TRIP Answers

9. Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes (Diagnosis)

the following: Constipation Nausea Urinary retention Erectile dysfunction Pure autonomic failure More specifically, symptoms of PAF include the following: Orthostatic hypotension: With an inappropriate lack of compensatory increase in heart rate with standing Gastroparesis: Associated with nausea or constipation Urinary retention: May cause bladder distention Decreased sweating: Manifesting as heat or exercise intolerance Ophthalmologic manifestations: Including ptosis, anisocoria, Horner syndrome (...) Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes (Diagnosis) Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

10. Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes (Treatment)

of the disorder. The treatment of chronic pure autonomic failure syndromes is symptomatic only. Postural orthostatic tachycardia syndrome can be treated by using low doses of beta-blockers as patients are normally sensitive to their adverse effects. Nonpharmacologic measures are useful for all patients with autonomic dysfunction. [ ] Discontinue antihypertensive medications and other medications known to lower blood pressure, if feasible. Increase fluid and salt intake. Equipment aids may be helpful (...) Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes (Treatment) Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes Treatment & Management: Medical Care, Activity Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

11. Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes (Overview)

the following: Constipation Nausea Urinary retention Erectile dysfunction Pure autonomic failure More specifically, symptoms of PAF include the following: Orthostatic hypotension: With an inappropriate lack of compensatory increase in heart rate with standing Gastroparesis: Associated with nausea or constipation Urinary retention: May cause bladder distention Decreased sweating: Manifesting as heat or exercise intolerance Ophthalmologic manifestations: Including ptosis, anisocoria, Horner syndrome (...) Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes (Overview) Idiopathic Orthostatic Hypotension and other Autonomic Failure Syndromes: Practice Essentials, Background, Pathophysiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache

2014 eMedicine.com

12. Orthostatic Intolerance: An overview

hypotension (NOH) since it can provide norepinephrine production through alternative pathways. [ ] Supportive therapy focuses on decreasing symptomatic OH and syncope. Such therapy would include physical countermaneuvers including compression garments, and dietary changes (increased salt, rapid water drinking). Supportive drug therapy often aims to increase blood volume by promoting salt and water retention (fludrocortisone) or by increasing red blood cell mass (recombinant erythropoietin). [ ] Defects (...) and patients with recurrent vasovagal syncope. Circulation . 2001. 104:898-902. . Chen L, Wang L, Sun J, Qin J, Tang C, Jin H and Du J. Midodrine hydrochloride is effective in the treatment of children with postural orthostatic tachycardia syndrome. Circ J . 2011. 75:927-931. . Claydon VE and Hainsworth R. Salt supplementation improves orthostatic cerebral and peripheral vascular control in patients with syncope. Hypertension . 2004. 43:809-813. . Claydon VE and Hainsworth R. Increased postural sway

2014 eMedicine Pediatrics

13. Orthostatic Intolerance: An overview

hypotension (NOH) since it can provide norepinephrine production through alternative pathways. [ ] Supportive therapy focuses on decreasing symptomatic OH and syncope. Such therapy would include physical countermaneuvers including compression garments, and dietary changes (increased salt, rapid water drinking). Supportive drug therapy often aims to increase blood volume by promoting salt and water retention (fludrocortisone) or by increasing red blood cell mass (recombinant erythropoietin). [ ] Defects (...) and patients with recurrent vasovagal syncope. Circulation . 2001. 104:898-902. . Chen L, Wang L, Sun J, Qin J, Tang C, Jin H and Du J. Midodrine hydrochloride is effective in the treatment of children with postural orthostatic tachycardia syndrome. Circ J . 2011. 75:927-931. . Claydon VE and Hainsworth R. Salt supplementation improves orthostatic cerebral and peripheral vascular control in patients with syncope. Hypertension . 2004. 43:809-813. . Claydon VE and Hainsworth R. Increased postural sway

2014 eMedicine Pediatrics

14. Orthostatic Hypotension

on inspiration on expiration Abnormal if <9 beat/min difference during cycle X. Evaluation See Consider intravascular volume replacement (IV Fluids) Consider causes above (including medications) XI. Complications Orthostatic Syncope XII. Management Avoid medications related to Orthostasis See Decrease dose or change medication to one less likey to cause Orthostatic Hypotension Consider stopping s, s Modify diet Increase salt Indicated for 24 hour urinary <170 mmol in 24 hours Supplement up to 1-2 grams extra (...) Orthostatic Hypotension Orthostatic Hypotension Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Orthostatic Hypotension Orthostatic

2015 FP Notebook

15. Orthostatic Hypotension

Hypotension In patients with orthostatic hypotension, which of the following red flag findings suggests a more serious etiology? Bloody stool Heat intolerance Incontinence Urinary retention NEWS & VIDEOS GDM Linked to Increased Cardiovascular Event Risk Postpartum FRIDAY, March 8, 2019 (HealthDay News) -- Women with gestational diabetes mellitus (GDM) have an increased risk fir developing cardiovascular events postpartum, according to a review published... 3D Model Cardiac Conduction System Video (...) vasomotor tone of the capacitance vessels. Simultaneous parasympathetic (vagal) inhibition also increases heart rate. In most people, changes in BP and heart rate upon standing are minimal and transient, and symptoms do not occur. With continued standing, activation of the renin-angiotensin-aldosterone system and vasopressin (ADH) secretion cause sodium and water retention and increase circulating blood volume. Etiology Homeostatic mechanisms may be inadequate to restore low BP if afferent, central

2013 Merck Manual (19th Edition)

17. Management of Poisoning

as unopposed alpha agonism may worsen accompanying hypertension (pg 57). Grade D, Level 3 D Physostigmine should be considered for treating tachycardia resulting from pure anticholinergic poisoning (pg 58). Grade D, Level 3 Executive summary of key recommendations2 GPP Lidocaine is the drug of choice for most ventricular arrhythmias due to drug toxicity (pg 58). GPP C Sodium bicarbonate should be used in impaired conduction defect caused by sodium channel blocking agents such as tricyclic antidepressants (...) , and external cooling measures for hyperthermia (>104°F or >40°C) seen with SSRI-induced serotonin syndrome. Institute emergency and supportive measures as they occur (pg 134). Grade D, Level 4 D Sodium bicarbonate may be used for QRS widening in patients with cardiac conduction abnormalities after SSRI poisoning. This reverses the sodium channel-dependent membrane depressant effects and may correct the cardiac conduction abnormalities (pg 134). Grade D, Level 4 GPP Provide IV ? uids and maintenance

2020 Ministry of Health, Singapore

18. Treatment of Patients with Schizophrenia

, or synthetic substances (e.g., "bath salts", K2, Spice). The route by which substances are used (e.g., ingestion, smoking, vaping, intranasal, intravenous) is similarly important to document. Mortality is increased in individuals with schizophrenia (Brown et al. 2000; Fazel et al. 2014; Olfson et al. 2015) and the average lifespan is shortened by a decade or more, with much of this decrease related to increased rates of co-occurring physical conditions (Laursen et al. 2013; Saha et al. 2007; Walker et al

2020 American Psychiatric Association

19. ESC/ESH Management of Arterial Hypertension Full Text available with Trip Pro

and diastolic blood pressure treatment targets3052 7.3.2 Blood pressure targets in specific subgroups of hypertensive patients3052 7.4 Treatment of hypertension3054 7.4.1 Lifestyle changes3054 7.4.2 Dietary sodium restriction3054 7.4.3 Moderation of alcohol consumption3055 7.4.4 Other dietary changes3055 7.4.5 Weight reduction3055 7.4.6 Regular physical activity3056 7.4.7 Smoking cessation3056 7.5. Pharmacological therapy for hypertension3056 7.5.1 Drugs for the treatment of hypertension3056 7.5.2 (...) Electrocardiogram eGFR Estimated glomerular filtration rate ELSA European Lacidipine Study on Atherosclerosis ENaC Epithelial sodium channel ESC European Society of Cardiology ESH European Society of Hypertension FEVER Felodipine Event Reduction HAS-BLED Hypertension, Abnormal renal/liver function (1 point each), Stroke, Bleeding history or predisposition, Labile INR, Elderly (>65), Drugs/alcohol concomitantly (1 point each) HbA1c Haemoglobin A1c HBPM Home blood pressure monitoring HDL-C HDL cholesterol HELLP

2018 European Society of Cardiology

20. Ertugliflozin l-pyroglutamic acid / metformin hydrochloride (Segluromet) - Diabetes Mellitus, Type 2

analysis plan SGLT1 sodium-glucose co-transporter 1 SGLT2 sodium-glucose co-transporter 2 SmPC summary of product characteristics SMQ Standard MedDRA Query SOC System organ class T2DM type 2 diabetes mellitus TAMC total aerobic microbial count Tmax time to first occurrence of maximum observed concentration TYMC total combined yeasts/moulds count UGE urinary glucose excretion ULN upper limit of normal US United States USPI United States Prescribing Information UTI urinary tract infection UV ultraviolet (...) the product This is an application for the use of ertugliflozin (MK-8835, PF-04971729) administered as a fixed-dose combination (FDC) with immediate-release metformin hydrochloride. Ertugliflozin is a new chemical entity belonging to the class of oral, sodium-glucose co-transporter 2 (SGLT2) inhibitors. The commercial formulation of the ertugliflozin/metformin FDC is a film-coated immediate-release tablet for oral administration available in 6 dose strengths to be dosed bid, four of these are proposed

2018 European Medicines Agency - EPARs

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