Clonidine
30
Summary
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Key Points
- Mechanism of Action (Saunders, Mictlan)
- Stimulates alpha-2-receptors
- Decreases sympathetic response, inhibiting vasoconstriction
- Reduces blood pressure and heart rate
- Metabolized by the liver
- Clinical Use (Saunders)
- Hypertension
- Can be given orally or as a transdermal patch
- Apply transdermal patch to a dry, hairless area on the upper arm or chest
- Patch must be replaced every 7 days, rotate sites with each new patch
- Wash hands before and after application
- Can be given orally or as a transdermal patch
- Opiate withdrawal
- Severe pain in cancer patients
- ADHD
- Hypertension
- Side Effects and Adverse Reactions (Saunders)
- Severe rebound hypertension if abruptly discontinued
- Due to the rapid surge of catecholamine secretion that was suppressed during therapy
- The patch should never be taken off abruptly; must be tapered off over 2-4 days
- Can lead to a hypertensive crisis
- Dry Mouth
- Medical term is xerostomia
- Can use hard candy, chewing gum, or over-the-counter moisturizers to relieve dry mouth
- Drowsiness
- Avoid use with alcohol, opioids, and other CNS depressants
- More common initially, will lessen with time
- Dizziness
- Dry mouth, drowsiness, and dizziness are often called the “3 D’s” of clonidine
- Hypotension
- Due to reduced sympathetic stimulation
- Carefully monitor blood pressure and avoid giving concurrently with diuretics
- Bradycardia
- Due to reduced sympathetic stimulation
- Abuse potential
- Not recommended for patients with a history of opioid dependence
- Teratogenic
- Not recommended for pregnant women
- Severe rebound hypertension if abruptly discontinued
- Stimulates alpha-2-receptors