Orthostatic hypotension due to quinidine and propranolol |
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| Authors: | N R Loon C S Wilcox W Folger |
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| Affiliation: | 1. Department of Obstetrics and Gynecology, Ain Shams University Hospital, Cairo, Egypt;2. Department of Obstetrics and Gynecology, Hendawy Medical Center, Abu Dhabi, United Arab Emirates;3. Dubai Fertility and Gynecology Center, Dubai, United Arab Emirates;1. ENT Unit, Department of Surgery, Arcispedale Santa Maria Nuova, Azienda USL - Center for Clinical and Basic Research (IRCCS), viale Risorgimento 80, 42123 Reggio Emilia, Italy;2. Audiology & Vestibology Service, Centromedico, Viale Officina 7, 6500 Bellinzona, Switzerland;3. ENT & Audiology Unit, Department of Experimental Diagnostic and Specialty Medicine (DIMES), S. Orsola - Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy;2. Department of Pathology, University of Pittsburgh Medical Center, UPMC Presbyterian, 200 Lothrop Street, Pittsburgh, PA 15213.;1. From Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland;2. Division of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan;3. Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada;4. PAREXEL International, Research Triangle Park, North Carolina;5. Clinical Development, Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline, Research Triangle Park, North Carolina;6. Clinical Development, Alternative Development Program, GlaxoSmithKline, King of Prussia, Pennsylvania. |
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| Abstract: | ![]()
Orthostatic hypotension developed in a 65-year-old man during treatment with quinidine and propranolol. Quinidine reduced standing blood pressure, attenuated the Valsalva response, and increased plasma norepinephrine concentrations, suggesting the presence of nonselective alpha-adrenergic blockade. The addition of propranolol inhibited the compensatory tachycardia and produced symptomatic orthostatic hypotension. Physicians should be alerted to the possibility of orthostatic hypotension when the alpha blocking effects of quinidine are combined with a beta blocking agent such as propranolol. |
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