Dihydroergotamine Treatment for Orthostatic Hypotension from Vacor Rodenticide
Authors: NEAL L. BENOWITZ
Journal: Annals of Internal Medicine (1980)

Brief Reports1 March 1980Dihydroergotamine Treatment for Orthostatic Hypotension from Vacor RodenticideNEAL L. BENOWITZ, M.D., RANDY BYRD, M.D., MORRIS SCHAMBELAN, M.D., JON ROSENBERG, M.D., MICHAEL F. ROIZEN, M.D.NEAL L. BENOWITZ, M.D.Search for more papers by this author, RANDY BYRD, M.D.Search for more papers by this author, MORRIS SCHAMBELAN, M.D.Search for more papers by this author, JON ROSENBERG, M.D.Search for more papers by this author, MICHAEL F. ROIZEN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-92-3-387 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWe report a case of severe orthostatic hypotension after ingestion of the rodenticide Vacor (Rohm and Haas Co., Philadelphia, Pennsylvania) in which hypotension remained incapacitating despite usual medical management. Dihydroergotamine remarkably improved postural blood pressure responses and enabled the patient to ambulate and care for himself.In a suicide attempt a 32-year-old man ingested one packet of Vacor (39 g, 2% N-3-pyridylmethyl-N'-p-nitrophenylurea). Shortly after ingestion he was hospitalized with hyperglycemic ketoacidosis, which was treated with insulin and fluids, and orthostatic hypotension was noted. Orthostatic syncope persisted over the next month despite treatment with lower extremity stockings and fludrocortisone, 0.3 mg/d,...References1. DEMANET J. Usefulness of noradrenaline and tyramine infusion tests in the diagnosis of orthostatic hypotension. Cardiology. 1976;61(suppl 1):213-24. CrossrefMedlineGoogle Scholar2. ROGERSBENOWITZWILSONABBOTT WNKJ. Effect of disulfiram on adrenergic function. Clin Pharmacol Ther. 1979; 25:469-77. CrossrefMedlineGoogle Scholar3. ROIZENMOSSHENRYKOPIN MJDI. Effects on halothane on plasma catecholamines. Anesthesiology. 1974;41:432-9. CrossrefMedlineGoogle Scholar4. KOPINLAKEZIEGLER IRM. Plasma levels of norepinephrine. Ann Intern Med. 1978;88:671-80. LinkGoogle Scholar5. PROSSERKARAM PJ. Diabetes mellitus following rodenticide ingestion in man. JAMA. 1978;239:1148-50. CrossrefMedlineGoogle Scholar6. KONTOSRICHARDSONNORVELL HDJ. Norepinephrine depletion in idiopathic orthostatic hypotension. Ann Intern Med. 1975;82:336-41. LinkGoogle Scholar7. MÜLLER-SCHWEINITZER E. Studies on the peripheral mode of action of dihydroergotamine in human and canine veins. Eur J Pharmacol. 1974;27:231-7. CrossrefMedlineGoogle Scholar8. MELLANDERNORDENFELT SI. Comparative effects of dihydroergotamine and noradrenaline on resistance, exchange and capacitance functions in the peripheral circulation. Clin Sci. 1970;39:183-201. CrossrefMedlineGoogle Scholar9. BEVEGÅRDCASTENFORSLINDBLAD SJL. Circulatory effects of dihydroergotamine in patients with disturbed sympathetic vasomotor control with special reference to postural hypotension. Cardiology. 1976;61(suppl 1):322-32. CrossrefMedlineGoogle Scholar10. JENNINGSESLERHOLMES GMR. Treatment of orthostatic hypotension with dihydroergotamine. Br Med J. 1979;2:307. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: San Francisco General Hospital Medical Center San Francisco, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPharmacotherapy of Cardiovascular Autonomic Dysfunction in Parkinson DiseaseCombination ergotamine and caffeine improves seated blood pressure and presyncopal symptoms in autonomic failurePostural HypotensionEMGT (Early Manifest Glaucoma Trial)Alpha sympathomimetic treatment of autonomic insufficiency with orthostatic hypotensionThe head and neck discomfort of autonomic failure: An unrecognized aetiology of headachePharmacokinetic data on analgesic and antimigraine agentsN-3-pyridylmethyl-N'-p-nitrophenylurea ocular toxicity in man and rabbits.Noradrenergic Responses in Postural Hypotension: Implications for TherapyOcular Ergotamine Tartrate Toxicity During Treatment of Vacor-Induced Orthostatic HypotensionManagement of Orthostatic Hypotension 1 March 1980Volume 92, Issue 3Page: 387-388KeywordsBlood pressureFludrocortisoneHypotensionIngestionInsulinSuicideSyncope Issue Published: 1 March 1980 PDF DownloadLoading ...