QuestionSBA
QuestionChoice
Daleparin does not commonly cause orthostatic hypotension
34224
e
Dalteparin sodium 2500 units SC OD
QuestionChoice
Amlodipine can cause dizziness but is not known to commonly cause orthostatic hypotension
34223
d
Amlodipine 5mg PO daily
QuestionChoice
Tamsulosin, an alpha1-adrenoreceptor blocker is known to cause postural hypotension due to the inhibition of alpha-1 receptors, leading to vascular smooth muscle relaxation and vasodilation the loss of reflex vasoconstriction upon standing
34220
a
Tamsulosin 400 micrograms PO OD
QuestionChoice
Carbamazepine does not commonly cause orthostatic hypotension
34222
c
Carbamazepine
QuestionChoice
Co-careldopa does not commonly cause orthostatic hypotension
34221
b
Co-careldopa 25/100 TDS PO
QuestionComment
The question says he has syncope. Syncope is common with bisoprolol.
Orthostatic hypotension is listed as not common for tamsulosin.
8522
QuestionComment
I'm guessing because the reason for his syncope is due to orthostatic hypotension and not b-blocker related (e.g., bradycardia)
16977
User
subscriber
Recessive Myotonia
User
subscriber
Juice Myopathy
QuestionComment
Why isn't bisoprolol an acceptable answer? Postural hypotension is listed as an uncommon side effect for both bisoprolol and tamsulosin.
40387
QuestionComment
I think because BNF has a whole caution section for tamsulosin about postural hypotension which bisoprolol doesn't ? 
40520
User
subscriber
Kinin Dominatrix
User
subscriber
Edema Power
QuestionComment
 postural hypotension is listed in the uncommon side effect section for both bisoprolol and tamsulosin. how are we meant to choose which one
40403
User
subscriber
Axillary Stasis
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2787
Alpha blockers and postural hypotension
Topic
74
Elderly Care
6855
Case Presentation: An 85-year-old man is transferred to the care of the elderly ward following an episode of syncope. PMH Hypertension, BPH, Epilepsy, Parkinson disease. DH His current regular medicines are listed (below).


On examination
Lying BP 120/85mmHg, HR 80/min; standing BP 90/70mmHg, HR 100/min

Question: Select the prescription that is most likely to contribute to his orthostatic hypotension.

a