Related Experiment Video
Updated: Dec 15, 2025
Disrupting Reconsolidation of Fear Memory in Humans by a Noradrenergic β-Blocker
Published on: December 18, 2014
Short-term efficacy of ORS formulation and propranolol regimen in children with POTS
Yilmaz Yozgat1, Hafize Otcu Temur2, Senay Coban3
1Department of Pediatric Cardiology, Bezmialem Vakif University, Istanbul, Turkey.
Insights
Reduced-osmolarity oral rehydration salt formulation (ORS) and propranolol significantly improved symptoms in children with postural orthostatic tachycardia syndrome (POTS). This combined treatment reduced symptom scores more effectively than no medication, improving daily activities for pediatric POTS patients.
Area of Science:
- Pediatric Cardiology
- Autonomic Dysfunction
- Clinical Pharmacology
Background:
- Postural orthostatic tachycardia syndrome (POTS) is a condition affecting children, characterized by orthostatic intolerance (OI).
- Head-up tilt testing (HUTT) is used to diagnose POTS, identifying significant heart rate increases and OI symptoms upon standing.
Purpose of the Study:
- To assess the short-term effectiveness of reduced-osmolarity oral rehydration salt formulation (ORS) combined with propranolol in pediatric patients with POTS.
- To compare the outcomes of this combined treatment against a control group receiving no medication.
Main Methods:
- Seventy pediatric patients diagnosed with POTS via HUTT were enrolled.
- Patients were divided into a study group (n=34) receiving reduced-osmolarity ORS and propranolol, and a control group (n=36) receiving no medication.
- Symptom frequency and standardized symptom scores were evaluated before and after a 3-month treatment period.
Main Results:
- Both groups showed a significant reduction in syncopal attacks post-treatment (P<0.01).
- The study group experienced a significantly greater reduction in standardized symptom scores for OI compared to the control group (P<0.01).
Conclusions:
- Combined reduced-osmolarity ORS and propranolol treatment effectively reduced OI symptoms and syncopal attacks in pediatric POTS patients.
- This therapeutic approach demonstrated superior efficacy in improving OI symptom scores compared to no medication.
- The study advocates for this combined treatment in managing pediatric POTS due to its clinical effectiveness and positive impact on daily functioning.
Background:
To evaluate the short-term effectiveness of reduced-osmolarity oral rehydration salt formulation (ORS) and propranolol in children diagnosed with postural orthostatic tachycardia syndrome (POTS) in head-up tilt testing (HUTT).
Methods:
Children were admitted with symptoms of orthostatic intolerance (OI) occurring in a standing position and disappearing in the supine position. Patients with heart rate increments of ≥40bpm and symptoms of OI constituted the pediatric POTS group in HUTT. A total of 70 pediatric patients with POTS were included in the study. POTS patients were divided into two groups based on whether they were prescribed reduced-osmolarity ORS and propranolol or not. The study group comprised patients on a regimen of reduced-osmolarity ORS and propranolol (n=34), while the control group comprised patients who were not prescribed any medication (n=36). The frequency of symptoms and standardized symptom scores were analyzed before and after 3 months of treatment in both groups.
Results:
The post-treatment frequency of syncopal attacks was significantly reduced in both groups (P<0.01 for both groups), but the post-treatment standardized symptom scores were significantly reduced in the pediatric study group compared with the control group (P<0.01).
Conclusion:
The frequency of syncopal attacks was significantly reduced and the symptom scores for OI were improved in the study group. The improvement in OI symptom scores was better in the treatment group than in the control group. The control group symptoms persisted and caused extreme difficulty in their daily activities. In view of its clinical efficacy, we strongly advocate the use of combined treatment of reduced-osmolarity ORS and low-dose propranolol in pediatric patients with POTS.
Related Concept Videos
01:27Adrenergic Antagonists: Pharmacological Actions of β-Receptor Blockers
01:23Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
01:24Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers
01:30Heart Failure V: Medical Management
01:22Dose-Response Relationship: Potency and Efficacy
01:28Antihypertensive Drugs: Types of β-Blockers