NURS 3331 Chapter Notes - Chapter 19: Transdermal Patch, Clonidine, Sympathetic Nervous System

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5 Feb 2017
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Chapter 19: Indirect-Acting Antiadrenergic Agents
Centrally Acting Alpha2 Agonists
- Primary use is for hypertension; act within the CNS to reduce the firing of
sympathetic neurons.
Clonidine [catapres, catapres-TTS, duraclon, kapvay, nexiclon, XR]
- Centrally acting alpha2 agonist with three approved indications:
o Hypertension sold as Catapres and Nexiclon XR
o Pain sold as Duraclon
o ADHD management sold as Kapvay
- Usually free of adverse effects and is administered wither orally or by transdermal
patch
- Mechanism of Antihypersensative Action -> clonidine causes selective activation of
alpha2 receptors in the CNS, especially in areas associated with autonomic
regulation of the cardiovascular system thus reducing the sympathetic outflow to
blood vessels and to the heart.
- Pharmacologic Effects -> can cause bradycardia and a decrease in cardiac output,
and b/c it suppresses the sympathetic regulation of blood vessels the drug promotes
asodilatio … resultig i a derease i lood pressure.
- Pharmacokinetics -> is lip
- id soluble, meaning that is readily absorbed once administered orally. Hypotensive
responses usually begin in 30 to 60 min after admin and peak around 4 hrs
- Therapeutic Uses -> Three approved applications: 1) hypertension 2) relief of severe
pain 3) management of ADHD
- Adverse Effects
o Drowsiness CNS depression is common. Reponses become less intense as
medication is continued. Activities that involve high alertness should be
avoided the first week
o Xerostoma dry outh is oo i alost half of patients, usually
ceases within 2-4 weeks of taking medication
o Rebound Hypertension a result of abrupt withdrawal of Clonidine. Caused
by overactivity of the sympathetic nervous system and is accompanied by
nervousness, tachycardia, and seating. Can be avoided by withdrawing over a
2-4 day period.
o Use in Pregnancy is NOT recommended for women who are pregnant
o Abuse those who abuse opioids and cocaine will usually abuse clonidine as
well. at high doses it can cause euphoria, sedation, hallucinations. It
sometimes used as a combination drug because it is less expensive.
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