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Toxicology – Drugs causing Hypotenssion
C – Clonidine:
A central-acting α₂ receptor agonist that can initially cause hypertension followed by hypotension.
C – Calcium Channel Blockers:
A class of antihypertensive and antianginal medications that decrease heart rate and dilate peripheral vasculature.
R – Reserpine:
A sympatholytic antihypertensive medication that blocks the reuptake of norepinephrine, dopamine, and serotonin, leading to enhanced degradation by MAO in the synaptic space.
A – Antidepressants:
Tricyclic antidepressants (TCAs) can induce hypotension through α₁ receptor blockade and by causing cardiac dysrhythmias and subsequent cardiac collapse.
A – Aminophylline:
A methylxanthine that acts as an adenosine receptor antagonist, β-blocker, and phosphodiesterase inhibitor that can cause hypotension and cardiac collapse in overdose settings.
S – Sedative–Hypnotics:
Hypotension can occur secondary to myocardial depression.
H – Heroin:
Opiates can induce hypotension secondary to histamine release, direct vasodilation, or through a centrally mediated decrease of vagal tone.
Treatment:
Hypotension is best treated with large fluid boluses followed by the administration of antidotes and/or treatment of the respective toxin. Pressors may be indicated if the patient remains hypotensive after fluid resuscitation.
C – Clonidine:
A central-acting α₂ receptor agonist that can initially cause hypertension followed by hypotension.
C – Calcium Channel Blockers:
A class of antihypertensive and antianginal medications that decrease heart rate and dilate peripheral vasculature.
R – Reserpine:
A sympatholytic antihypertensive medication that blocks the reuptake of norepinephrine, dopamine, and serotonin, leading to enhanced degradation by MAO in the synaptic space.
A – Antidepressants:
Tricyclic antidepressants (TCAs) can induce hypotension through α₁ receptor blockade and by causing cardiac dysrhythmias and subsequent cardiac collapse.
A – Aminophylline:
A methylxanthine that acts as an adenosine receptor antagonist, β-blocker, and phosphodiesterase inhibitor that can cause hypotension and cardiac collapse in overdose settings.
S – Sedative–Hypnotics:
Hypotension can occur secondary to myocardial depression.
H – Heroin:
Opiates can induce hypotension secondary to histamine release, direct vasodilation, or through a centrally mediated decrease of vagal tone.
Treatment:
Hypotension is best treated with large fluid boluses followed by the administration of antidotes and/or treatment of the respective toxin. Pressors may be indicated if the patient remains hypotensive after fluid resuscitation.
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