After 10 weeks, plasma triglyceride and 15-F2t-isoprostane, and insulin sensitivity were measured, and after 12 weeks, pressor response to methoxamine
(15-60 microg/kg min) was assessed.
These include (29): endothelium-derived contracting factors such as endothelin, prostanoids such as thromboxane A2 and prostaglandin F2[alpha], circulating sympathomimetics ([alpha]-adrenoceptor agonists) such as norepinephrine and synthetic [alpha]l-adrenoceptor agonists like methoxamine
or phenylephrine, platelet-derived substances such as 5-hydroxytryptamine and thromboxane A2, mast cells- or basophils-derived substances like histamine, muscarinic receptor agonists such as acetylcholine, renin-angiotensin system related substances such as angiotensin II and depolarizing potassium ions.
Examples of these agents used off-label are the nonsubtype-selective agonists ephedrine, pseudoephedrine, norephedrine (synonymous with phenylpropanolamine or PPA), and norfenefrine, as well as the subtype-selective [alpha]1-adrenergic receptor agonists midodrine and methoxamine.
Effect of methoxamine on maximum urethral pressure in women with genuine stress incontinence: a placebo-controlled, double-blind crossover study.
Use of methoxamine
in the resuscitation of epinephrine-resistant electromagnetic dissociation.
In patients with chronic PHT, phenylephrine, methoxamine (130) and noradrenaline all increase the MAP and right coronary blood flow.
In summary, noradrenaline is superior to methoxamine and phenylephrine for the treatment of RV dysfunction due to PHT, while vasopressin should be considered for refractory cases.