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Treatment of Severe Orthostatic Hypotension by Metoclopramide

OTTO KUCHEL, M. D., Sc.D.; NGUYEN T. BUU, Ph.D.; JOLANTA GUTKOWSKA, Ph. D.; and JACQUES GENEST, M.D., D.Sc
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Supported by a grant from the Medical Research Council of Canada to a multidisciplinary group of hypertension.

▸Requests for reprints should be addressed to Otto Kuchel, M.D.; Clinical Research Institute, 110 Pine Avenue West; Montreal, Quebec, Canada H2W 1R7.


Clinical Research Institute and HÔtel-Dieu Hospital, University of Montreal; Montreal, Quebec,Canada.


Ann Intern Med. 1980;93(6):841-843. doi:10.7326/0003-4819-93-6-841
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The cardiovascular consequences of a deficient release of norepinephrine at nervous terminals are dependent on its balance with some vasodilator and natriuretic substances (bradykinin, some prostaglandins, and dopamine [for review see Reference I]) whose action is opposite that of norepinephrine. Treatment by substances that inhibit bradykinin and prostaglandin action or synthesis proved effective in many cases of orthostatic hypotension (2). We have reported (3) that in severe orthostatic hypotension with increased urinary dopamine excretion the condition has been considerably improved by treatment with carbidopa, a peripheral inhibitor of dopamine synthesis. The introduction of an assay for conjugated dopamine in plasma

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