Mojtahedzadeh Mojtaba, Taghvaye-Masoumi Hamidreza, Najafi Atabak, Dianatkhah Mehrnoush, Sharifnia Hamidreza, Shahrokhi Maryam
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology and Intensive Care, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Pharm Res. 2019 Fall;18(4):2131-2135. doi: 10.22037/ijpr.2019.1100824.
Spinal cord injury is a devastating chronic condition resulting in temporary or permanent motor, sensory or autonomic dysfunction of the cord. The manifestation of spinal cord injury based on the severity and involved areas could be different. Numerous studies have demonstrated that bradycardia, hypotension, and orthostatic hypotension are present insignificant number of patients after spinal cord injury which peaks at 4 day of injury. Although vasopressors are common drugs that have been used to restore blood pressure and heart rate in patients with neurogenic shock, there is limited data regarding pharmacologic management of bradycardia and hypotension after spinal cord injury. Midodrine is a potent vasopressor approved for the management of symptomatic orthostatic hypotension. Theophylline and aminophylline are methylxanthine derivatives. There are very few case reports concerning the use of midodrine and methylxanthines for treatment of hypotension in patients with spinal cord injury. In this case report and review of the articles we report a 45 year old woman with a diagnosis of spinal cord injury who was successfully managed with midodrine and aminophylline and then we review current case reports. Based on our case report and other available data, midodrine as well as methylxanthines can be suggested as therapeutic options for managing symptoms in spinal cord injury patients.
脊髓损伤是一种破坏性的慢性疾病，会导致脊髓出现暂时或永久性的运动、感觉或自主神经功能障碍。根据严重程度和受累区域的不同，脊髓损伤的表现可能有所差异。大量研究表明，脊髓损伤后的许多患者会出现心动过缓、低血压和体位性低血压，在损伤后第4天达到峰值。虽然血管升压药是用于恢复神经源性休克患者血压和心率的常用药物，但关于脊髓损伤后心动过缓和低血压的药物治疗数据有限。米多君是一种被批准用于治疗症状性体位性低血压的强效血管升压药。茶碱和氨茶碱是甲基黄嘌呤衍生物。关于使用米多君和甲基黄嘌呤治疗脊髓损伤患者低血压的病例报告非常少。在本病例报告及文章综述中，我们报告了一名45岁诊断为脊髓损伤的女性患者，她通过米多君和氨茶碱成功得到治疗，然后我们回顾了当前的病例报告。根据我们的病例报告和其他现有数据，米多君以及甲基黄嘌呤可被建议作为治疗脊髓损伤患者症状的治疗选择。
