c




  antihypertensives

 
 clonidine



 
 Catapres, Catapress-TTS



 
  PO (adults): a

  100mcg (0.1mg) bid, increase by 100-200 mcg (0.1-0.2mg)/ day q 2-4 days. 
  is 200-600mcg (0.2-0.6mg)/ day in 2-3 divided dose.   200mcg (0.2mg) loading dose, then 100mcg q hr until
blood pressure is controlled or 800mcg total has been discontinued. PO (geriatric) 100mcg at bedtime initially, increased as needed. PO
(children) 50-400mcg twice daily. Transdermal (adults) 
 transdermal system delivering 100-300mcg /24 hour system. Epidural
(adults): 30mcg/hr initially, titrated according to need; Epidural (children) 0.5mcg/kg/hr initially titrated according to need.

  
 PO, Transdermal, Epidural

 
  Stimulates alpha-adrenergic receptors in the CNS; which results in decreased sympathetic outflow inhibiting cardioacceleration
and vasoconstriction centers. Prevents pain signal transmission to the CNS by stimulating alpha-adrenergic receptors in the spinal cord.


   
  PO, Transdermal: Management of mild to moderate hypertension. Epidural: Management of cancer pain
unresponsive to opioid alone


   drowsiness, depression, dizziness, nervousness, nightmares, Bradycardia, hypotension, palpations, dry mouth,
constipation, nausea, vomiting, erectile dysfunction, rash, sweating, sodium retention, weight gain

  
 
!  Monitor intake and output ratios and daily weight, and assess for edema daily, especially at
beginning of therapy. Monitor blood pressure and pulse frequently. Instruct patient to take at the same time each day, even if feeling well,
Caution patient to avoid sudden changes in position to decreases orthostatic hypotension. Use of alcohol, standing for long periods, exercising,
and hot weather may increase orthostatic hypotension. If dry mouth occurs, frequent mouth rinses, good oral hygiene, and sugarless gum may
decrease effect. Encourage patient to comply with additional intervention for hypertension (weight reduction, low-sodium diet, discontinuation
of smoking, moderation of alcohol consumption, regular exercise, and stress management). Insturct patient and family on proper technique for
blood pressure monitoring.

 Deglin, J.H., Vallerand, A.H., „
„ 

 11/e, Philadelphia: Davis, 2009