Clonidine (and Guanfacine)
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Sympathomimetics and Sympatholytics (Old)
- Dopamine
- Fenoldopam
- Dobutamine
- Epinephrine
- Norepinephrine
- Isoproterenol
- Midodrine
- Phenylephrine and Pseudoephedrine
- (Alpha) Methyldopa
- Clonidine (and Guanfacine)
- Tizanidine
Summary
Clonidine is an alpha 2 activating drug used to treat hypertensive urgency and ADHD. Stopping clonidine quickly may cause rebound hypertension.
Key Points
- Clonidine, Guanfacine
- Mechanism
- Centrally-acting alpha-2 receptor agonists
- Sympatholytic (inhibits fight-or-flight response)
- ↓ central adrenergic outflow lowering neuronal norepinephrine release to the heart and systemic circulation
- Centrally-acting alpha-2 receptor agonists
- Indication
- Hypertension
- Including hypertensive urgency
- ADHD
- Second-line after stimulants (e.g. methylphenidate)
- Tourette Syndrome
- Specifically for intractable tics associated with TS
- Symptom control in opioid withdrawal
- Hypertension
- Side Effects
- Rebound hypertension with abrupt cessation
- CNS depression
- Bradycardia, hypotension, respiratory depression, miosis
- Impotence
- Does not decrease renal blood flow (MB)
- Mechanism