Outline of the major actions by which a variety of drugs may reduce postural hypotension
| Reducing salt loss/plasma volume expansion: |
|---|
| Mineralocorticoids (fludrocortisone) |
| Reducing nocturnal polyuria: |
| Vasopressin-2-receptor agonists (desmopressin) |
| Vasoconstriction: sympathetic: |
| Directly on resistance vessels (midodrine, phenylephrine, noradrenaline, clonidine) and on capacitance vessels (dihydroergotamine) |
| Indirectly (ephedrine, tyramine with monoamine oxidase inhibitors, yohimbine) |
| Prodrug (L-threo-dihydroxyphenylserine) |
| Vasoconstriction: non-sympathetic |
| Vasopressin-1 agonists (terlipressin) |
| Preventing vasodilatation: |
| Prostaglandin synthetase inhibitors (indomethacin, flurbiprofen) |
| Dopamine receptor blockade (metoclopramide, domperidone) |
| β2-Adrenoceptor blockade (propranolol) |
| Preventing postprandial hypotension: |
| Adenosine receptor blockade (caffeine) |
| Peptide release inhibitors (somatostatin analogue: octreotide) |
| Increasing cardiac output: |
| β Blockers with intrinsic sympathetic activity (pindolol, xamoterol) |
| Dopamine agonists (ibopamine) |
| Increasing red cell mass: |
| Recombinant erythropoietin |