The Pharmacological Management of Hypotension

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Hypotension is characterized by low blood pressure measured less than 90mmHg systolic and less than 60mmHg diastolic pressures. The main causes have cardiac and vascular origins and could be traumatic or non-traumatic. There are different types of hypotension namely orthostatic, neurally mediated, severe hypotension with shock, postprandial hypotension and chronic asymptomatic hypotension. Orthostatic hypotension affects largely the older population above 70 years but can affect any age and sex. Chronic asymptomatic ;hypotension is most times not diagnosed early enough until it has progressed to a later and dangerous state that could lead to shock if circulation is not restored. Neurally mediated hypotension is common in infants and children. Hypotension is diagnosed from presenting symptoms ranging from dizziness, lethargy, dyspnoea, loss of consciousness, blurred vision, chest pain to dysmenorrhea and sexual dysfunction in men. A full medical history, physical (ECG, ECHO, Valsalva manoeuvre, Stress test) and blood test are required to diagnose hypotension and the underlying condition if any. Management of hypotension is dependent on the type and underlying cause. There’s the nonpharmacological approach that involves lifestyle modification, manoeuvres, avoiding the drug/ agent increasing the risk for hypotension and the pharmacological methods using corticoids, fluid replacement, vasopressor, erythropoietin, somatostatin analogues to mention a few.

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Hypotension and it's treatment approach
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