ArticlePM & R : the journal of injury, function, and rehabilitation2023
Autonomic dysreflexia: Current pharmacologic management.
Article in PM & R : the journal of injury, function, and rehabilitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- Clinical management of complications after chronic spinal cord injury: a review of recent advances.Annals of medicine · 2026Review
- Spinal Cord Ischemia After Thoracoabdominal Aortic Aneurysm Repair: Pathophysiology, Detection, and Management.Neurology international · 2026Review
- Increased symptomatic autonomic dysfunction is associated with greater cardiovascular endothelial dysfunction following spinal cord injury.PM & R : the journal of injury, function, and rehabilitation · 2026Article
- Correlating autonomic physiology with symptoms of autonomic dysreflexia after spinal cord injury.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Autonomic dysreflexia with relative tachycardia: Potential physiologic pathways for this head scratching clinical finding.PM & R : the journal of injury, function, and rehabilitation · 2025Article
- Autonomic impairment is not explained by neurological level of injury or motor-sensory completeness.Spinal cord · 2024Article
- Why do different people with Spinal Cord Injury have differing severity of symptoms with Autonomic Dysreflexia? Exploring relationships of vascular alpha-1 adrenoreceptor and baroreflex sensitivity after SCI.medRxiv : the preprint server for health sciences · 2024Article
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
Abstract
backgroundAutonomic dysreflexia (AD) is a frequent complication of spinal cord injury (SCI), though current clinical practice patterns for medication management of this condition are unknown. Correspondingly, it is unclear if national differences in practice patterns exist.
objectiveTo determine trends in current pharmacologic management of AD throughout the Americas.
designInternational survey of current physician practice patterns.
settingAcademic medical center.
participantsSixty physicians managing patients with SCI and prescribing medications to manage AD.
interventionsNot applicable.
main outcome measuresPresence of a formal pharmacologic AD management protocol, first- and second-line medications, patient characteristics influencing pharmacologic management.
resultsThe majority of physicians (69%) had a formal AD management protocol for inpatient care, with nitroglycerin ointment (82%) being the most common first-line medication. Strong national differences existed regarding the use of nitroglycerin ointment, with 98% of U.S.-based physicians using this as first-line medication and 0% of physicians in Canada or Latin America using this due to recent lack of medication availability. Only 67% of physicians had a preferred second-line medication, with preferences split between hydralazine (48%) and nifedipine (28%). A systolic blood pressure threshold for pharmacologic management was used by 56% of physicians, wheres 26% considered neurological level of injury in decisions to use medications for AD. Heart rate was used by only 5% of physicians in their decision to manage AD with medications.
conclusionsAs of 2023, U.S.-based physicians caring for individuals with SCI largely have formal inpatient protocols in place for medication management of AD, with nearly all relying on nitroglycerin ointment as their first-line medication. In areas outside of the United States where nitroglycerin ointment is unavailable, pharmacologic practice patterns significantly differ.
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Registered trials
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