Pyridostigmine in the Treatment of Orthostatic Intolerance

@article{Gales2007PyridostigmineIT,
  title={Pyridostigmine in the Treatment of Orthostatic Intolerance},
  author={B. J. Gales and M. Gales},
  journal={Annals of Pharmacotherapy},
  year={2007},
  volume={41},
  pages={314 - 318}
}
Objective: To review the efficacy of pyridostigmine bromide for the treatment of orthostatic intolerance. Data Sources: MEDLINE and International Pharmaceutical Abstracts were searched (1966–December 2006) using the terms pyridostigmine, acetylcholinesterase inhibitor, orthostatic intolerance, orthostatic hypotension, neurogenic orthostatic hypotension, postural tachycardia syndrome, tachycardia, and orthostatic tachycardia. Study Selection and Data Extraction: Pertinent English-language human… Expand
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  • Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
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A retrospective, single‐center, long‐term experience regarding the efficacy and adverse effect profile of pyridostigmine in the treatment of POTS patients is reported. Expand
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References

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Pyridostigmine treatment trial in neurogenic orthostatic hypotension.
TLDR
Pyridostigmine significantly improves standing BP in patients with OH without worsening supine hypertension, suggesting that the improvement is due to increased total peripheral resistance. Expand
Acetylcholinesterase Inhibition in Patients With Orthostatic Intolerance
TLDR
It is concluded that pyridostigmine improves orthostatic tolerance in patients with OI and support the suggested mechanisms of enhanced sympathetic ganglionic neurotransmission and a vagal shift in cardiac sympathovagal balance. Expand
Acetylcholinesterase inhibition: a novel approach in the treatment of neurogenic orthostatic hypotension
TLDR
This novel approach to treatment using acetylcholinesterase inhibition appears effective in the treatment of neurogenic orthostatic hypotension, specially for patients with a high supine blood pressure. Expand
Pharmacokinetics of Pyridostigmine in a Child With Postural Tachycardia Syndrome
TLDR
The pharmacokinetic evaluation of pyridostigmine in children with myasthenia and a pediatric index patient with severe postural orthostatic tachycardia syndrome revealed a short half-life, suggesting that dosing 3 times per day is preferable. Expand
Acetylcholinesterase inhibition and orthostatic hypotension
TLDR
The case of a 68 years old woman who, over the years, developed a progressive autonomic failure due to postganglionic cholinergic denervation, suggests that pyridostigmine does not only affect orthostatic, but also supine BP and heart rate and advises caution in prescribing it to patients at risk of supine hypertension and arrhythmias. Expand
Acetylcholinesterase Inhibition Improves Tachycardia in Postural Tachycardia Syndrome
TLDR
Acute acetylcholinesterase inhibition significantly attenuated tachycardia in POTS and there was also an improvement in symptom burden with this promising therapy. Expand
Putting it together: a new treatment algorithm for vasovagal syncope and related disorders.
TLDR
New guidelines for the diagnosis and treatment of patients with vasovagal syncope are proposed, an amalgam of clinical experience, expert opinion, and research evidence; however, they do not suggest a standard of care for all patients. Expand
Pyridostigmine for treatment of neurogenic orthostatic hypotension [correction of hypertension]--a follow-up survey study.
TLDR
The result of a follow-up, open-label study of pyridostigmine for treatment of orthostatic hypotension was that most patients were very satisfied with the medication and chose to continue it. Expand
Neurocardiogenic Syncope and Related Disorders of Orthostatic Intolerance
TLDR
The present system of classification has proven both functional and clinically relevant and includes a group of disorders that most investigators have thought to be principally autonomic in nature. Expand
The Elusive Pathophysiology of Neurally Mediated Syncope
TLDR
This review critically evaluates proposed theories that attempt to explain the pathophysiological mechanisms of Neurally mediated syncope (NMS), a common clinical problem that affects up to 3.5% of the general population. Expand
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