Podcasts · Core IM | Internal Medicine Podcast

#188 Orthostatic Hypotension Part 2: Gray Matters Segment

22 Sep 2025 · 36 min

Medications for orthostatic hypotension! When to initiate treatment, how to use them safely, and what to do when new issues arise during treatment. How do those change if someone has autonomic failure? What do you do when your patient has hypertension AND also has orthostatic hypotension?

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🔹 Transcript & Show Notes

Timestamps (+/- 1-2 mins):

(00:28) | Case Recap: Beyond Non-Pharm Strategies

(03:07) | Midodrine: Timing, Testing, & Supine Hypertension

(06:23) | Fludrocortisone: Benefits vs. Risks

(09:01) | Droxidopa: Evidence, Side Effects, Access Issues

(10:11) | Pyridostigmine & NSAIDs: Secondary Options

(12:31) | Balancing Hypertension and Orthostatic Hypotension

(14:29) | Functional Hypotension & Risk Stratification

(18:45) | Symptomatic Patients: What to Stop, What to Continue

(20:19) | Autonomic Disease: Supine & Nocturnal Hypertension

(21:47) | Bed Elevation, Compression, & Non-Pharm Pearls

Tags: Internal Medicine, Geriatrics, Autonomic Dysfunction, Hypertension, Syncope, Falls, Patient Safety, Medical Education, physician assistant, nurse practitioner, hospitalist, primary care, neurology

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