Q: Autonomic dysfunction induced hypotension is common in ICU and may become challenging in weaning vasopressors. All of the following can be used as treatment or as an adjuvant treatment in orthostatic hypotension?

A)  Fludrocortisone 
B)  Midodrine
C)  Recombinant erythropoietin 
D)  Nonsteroidal antiinflammatory drugs (NSAID)
E) All of the above


Answer: E

Like most MCQs, answer to above question is E (all of the above)!!!

 Objective of above question to bring in light, the help of recombinant erythropoietin in patients with chronic anemia to counter autonomic hypotension. Also, Nonsteroidal antiinflammatory drugs (NSAID) may be of help too in combination with other agents.

There is a long list of medicines which have been tried either solo or in combinations with various success in autonomic dysfunction induced hypotension including midodrine, pyridostigmine, caffeine, synthetic vasopressin analogue desmopressin (dDAVP), Yohimbine, octreotide, dihydroergotamine, droxidopa, atomexitine and others.