Description of the medicine: Midodrine (Midodrine)
MIDODRINE (Midodrine) *. (#) - 2-amino-N- (2, 5-dimethoxy-b-hydroxyphenethyl) acetamide.
Synonyms: Gutron (The name of the drug is "Hafslund Nycomed Pharma AG"), Alphamine, Gutron, Hipertan, Midamine, etc.
Available in the form of hydrochloride.
According to the chemical structure and pharmacological properties, midodrine is close to adrenaline-like sympathomimetic substances. It has a vasoconstrictor and pressor (hypertensive) effect. Like norepinephrine and mesatone, it stimulates mainly a-adrenergic receptors, with little effect on b-adrenergic receptors; It has no significant effect on heart rate, myocardial contractility, and also on the muscles of the bronchi.
In an organism midodrin is hydrolyzed with formation of an active metabolite of de-glimidodrin and aminoacetic acid (see. Glycine).
De-glimidodrine has a significantly stronger vasoconstrictor (sympathomimetic) action than the initial midodrine compound; thus, midodrine is regarded as a “prodrug” from which an active substance is formed during metabolism (see Introduction, Epinephrine, Epinephrine Diphvilate, Dipivefrin).
Hydrolysis of midodrine in the body occurs gradually, and the vasoconstrictor effect develops more slowly and more evenly than with the use of norepinephrine, mesatone, and fetanol.
When administered, midodrine is well absorbed, it is detected in blood plasma after 10 minutes; the maximum concentration is noted after 2 hours. The half-life is 3-4 hours. The drug and its metabolites are excreted mainly by the kidneys.
Midodrin is used for various types of hypotension: with orthostatic hypotension due to impaired tone of the sympathetic nervous system, with idiopathic orthostatic hypotension, secondary hypotension associated with infectious diseases, injuries, and the use of drugs.
Apply midodrine orally and intravenously.
Inside, usually 1 tablet is prescribed, containing 2, 5 mg 2 (less often than 3) times a day or 7 drops of a 1% solution 2 times a day. When the clinical effect is achieved and for long-term therapy, 1/2 tablet (1, 25 mg) is prescribed 2 times a day or 3 drops of a 1% solution 2 times a day. In some cases, initially prescribed 2 tablets (5 mg) 2 times a day.
If necessary, the contents of 1 ampoule (5 mg) 2 times a day are administered intravenously.
Treatment with midodrine should be carried out under the control of blood pressure and other hemodynamic parameters. If the dose is exceeded or individual hypersensitivity occurs, a hypertensive reaction, bradycardia, increased sweating, pilomotor reaction ("goose bumps"), and urination disorders (delay and increased frequency) are possible.
The drug is contraindicated in hypertension, pheochromocytoma, spastic and obliterating diseases of peripheral vessels, thyrotoxicosis, prostate adenoma, angle-closure glaucoma.