0
July 10, 1987, Vol 258, No. 2 >
ARTICLE | July 10, 1987

The Potent Pressor Effect of Phenylpropanolamine in Patients With Autonomic Impairment FREE

Italo Biaggioni, MD; Jack Onrot, MD; Cheryl K. Stewart; David Robertson, MD
[+] Author Affiliations

Preliminary results of this work were presented at the annual meeting of the American Federation for Clinical Research, San Diego, May 3, 1987, and have been published in Clinical Research (1987;35:373A).

Reprint requests to Autonomic Dysfunction Clinic, Division of Clinical Pharmacology, Vanderbilt Medical School, Nashville, TN 37232 (Dr Biaggioni).


JAMA. 1987;258(2):236-239. doi:10.1001/jama.1987.03400020078035
Text Size: A A A
Published online
Article
References

We determined the pressor effect of phenylpropanolamine hydrochloride, a widely used sympathomimetic agent, in 14 patients with autonomic failure and orthostatic hypotension. Blood pressure was monitored every five minutes in the sitting position with an automated device. Oral administration of 25 mg of phenylpropanolamine hydrochloride in nine patients produced significant increases in systolic (32 mm Hg), diastolic (15 mm Hg), and mean (21 mm Hg) blood pressures. The pressor effect appeared within the first 60 minutes and was still present at 105 minutes. There was no change in heart rate. Blood pressure was also significantly raised by administration of 12.5 mg of oral phenylpropanolamine hydrochloride in five additional patients. We conclude that administration of 25 mg of phenylpropanolamine hydrochloride elicits a potent pressor response in patients with orthostatic hypotension and that significant hypertension may result.

(JAMA 1987;258:236-239)

REFERENCES

1 +
Pentel P:  Toxicity of over the counter stimulants . JAMA 1982;;252:1898-1903.
2 +
Robertson D, Hollister AS, Carey EL, et al:  Vascular β2-adrenergic hypersensitivity in autonomic dysfunction . J Am Coll Cardiol 1984;;3:850-856.
3 +
Onrot J, Goldberg MR, Hollister AS, et al:  Management of chronic orthostatic hypotension . Am J Med 1986;;80:454-464.
4 +
Robertson D:  Assessment of autonomic function , in Baughman KL, Green BM (eds): Manual for Houseofficers . Baltimore, Williams & Wilkins, 1981;, pp 86-131.
5 +
Gourdeau M, Martin R, Lamarche Y, et al:  Oscillometry and direct blood pressure: A comparative clinical study during deliberate hypotension . Can Anaesth Soc J 1986;;33:300-307.
6 +
Trendelenburg U, Muskus A, Fleming WW, et al:  Effects of cocaine, denervation and decentralization on the response of the nictitating membrane to various sympathomimetic amines . J Pharmacol Exp Ther 1962;;138:181-193.
7 +
Pentel PR, Aaron C, Paya C:  Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure . Int J Obes 1985;;9:115-119.
8 +
Onrot J, Goldberg MR, Biaggioni I, et al:  Hemodynamic and humoral effects of caffeine in autonomic failure: Therapeutic implications for postprandial hypotension . N Engl J Med 1985;;313: 549-554.
9 +
Onrot J, Goldberg MR, Biaggioni I, et al:  Oral yohimbine in human autonomic failure . Neurology 1987;;36:215-220.
10 +
Hines S, Houston M, Robertson D:  The clinical spectrum of autonomic dysfunction . Am J Med 1981;;70:1091-1096.
11 +
Mann S, Bellamy GR, Hunyor SN, et al:  Supine hypertension, blood pressure variability and circadian rhythm in autonomic failure: The role of ambulatory intra-arterial monitoring . Clin Exp Pharmacol Physiol 1984;;11:347-350.
12 +
Lasagna L:  Phenylpropanolamine and blood pressure . JAMA 1985;;253:2491-2492.
13 +
Goodman RP, Wright JT, Barlascini CO, et al:  The effect of phenylpropanolamine on ambulatory blood pressure . Clin Pharmacol Ther 1986;;40: 144-147.
14 +
Pentel PR, Asinger RW, Benowitz NL:  Propranolol antagonism of phenylpropanolamineinduced hypertension . Clin Pharmacol Ther 1985;; 37:488-494.
15 +
Pentel PR, Mikell FL, Zavoral JH:  Myocardial injury after phenylpropanolamine ingestion . Br Heart J 1982;;47:51-54.
16 +
Pentel P, Mikell F:  Reaction to phenylpropanolamine/chlorpheniramine/belladonna compound in a woman with unrecognized autonomic dysfunction . Lancet 1982;;2:274.
17 +
Sachs C, Kaijser L:  Autonomic cardiovascular responses in old age . Clin Physiol 1985;;5:347-357.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Pentel P:  Toxicity of over the counter stimulants . JAMA 1982;;252:1898-1903.
2 +
Robertson D, Hollister AS, Carey EL, et al:  Vascular β2-adrenergic hypersensitivity in autonomic dysfunction . J Am Coll Cardiol 1984;;3:850-856.
3 +
Onrot J, Goldberg MR, Hollister AS, et al:  Management of chronic orthostatic hypotension . Am J Med 1986;;80:454-464.
4 +
Robertson D:  Assessment of autonomic function , in Baughman KL, Green BM (eds): Manual for Houseofficers . Baltimore, Williams & Wilkins, 1981;, pp 86-131.
5 +
Gourdeau M, Martin R, Lamarche Y, et al:  Oscillometry and direct blood pressure: A comparative clinical study during deliberate hypotension . Can Anaesth Soc J 1986;;33:300-307.
6 +
Trendelenburg U, Muskus A, Fleming WW, et al:  Effects of cocaine, denervation and decentralization on the response of the nictitating membrane to various sympathomimetic amines . J Pharmacol Exp Ther 1962;;138:181-193.
7 +
Pentel PR, Aaron C, Paya C:  Therapeutic doses of phenylpropanolamine increase supine systolic blood pressure . Int J Obes 1985;;9:115-119.
8 +
Onrot J, Goldberg MR, Biaggioni I, et al:  Hemodynamic and humoral effects of caffeine in autonomic failure: Therapeutic implications for postprandial hypotension . N Engl J Med 1985;;313: 549-554.
9 +
Onrot J, Goldberg MR, Biaggioni I, et al:  Oral yohimbine in human autonomic failure . Neurology 1987;;36:215-220.
10 +
Hines S, Houston M, Robertson D:  The clinical spectrum of autonomic dysfunction . Am J Med 1981;;70:1091-1096.
11 +
Mann S, Bellamy GR, Hunyor SN, et al:  Supine hypertension, blood pressure variability and circadian rhythm in autonomic failure: The role of ambulatory intra-arterial monitoring . Clin Exp Pharmacol Physiol 1984;;11:347-350.
12 +
Lasagna L:  Phenylpropanolamine and blood pressure . JAMA 1985;;253:2491-2492.
13 +
Goodman RP, Wright JT, Barlascini CO, et al:  The effect of phenylpropanolamine on ambulatory blood pressure . Clin Pharmacol Ther 1986;;40: 144-147.
14 +
Pentel PR, Asinger RW, Benowitz NL:  Propranolol antagonism of phenylpropanolamineinduced hypertension . Clin Pharmacol Ther 1985;; 37:488-494.
15 +
Pentel PR, Mikell FL, Zavoral JH:  Myocardial injury after phenylpropanolamine ingestion . Br Heart J 1982;;47:51-54.
16 +
Pentel P, Mikell F:  Reaction to phenylpropanolamine/chlorpheniramine/belladonna compound in a woman with unrecognized autonomic dysfunction . Lancet 1982;;2:274.
17 +
Sachs C, Kaijser L:  Autonomic cardiovascular responses in old age . Clin Physiol 1985;;5:347-357.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
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.
Note: You must get at least of the answers correct to pass this quiz.
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:
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.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

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

Related Content

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

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems