We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Autonomic Hyperreflexia

Glen W. Sizemore, MD; W. W. Winternitz, MD
JAMA. 1970;214(10):1886. doi:10.1001/jama.1970.03180100076020.
Text Size: A A A
Published online


To the Editor.—  Neider et al stated in their article "Autonomic Hyperreflexia in Urologic Surgery" (213: 867, 1970) that sympatholytic agents have been ineffective for the treatment of autonomic hyperreflexia. We have previously presented1 two patients who responded to such agents, namely the α-adrenergic blocking agents phentolamine (Regitine) or phenoxybenzamine hydrochloride (Dibenzyline) or both. We proposed and demonstrated that doses larger than 5 mg of phentolamine might be needed to control the hypertensive paroxysms of autonomic hyperreflexia. In Nieder's patient the blood pressure decrease from 235/ 130 mm Hg to 190/110 mm Hg could have represented direct vasodilatation,2 but it is also possible that a repeated or larger dose of phentolamine may have controlled the hypertension.We agree with the authors that in most cases the more permanent methods of management are unnecessary. We suggest that the use of α-adrenergic blocking agents will also reduce the need for


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.