Alpha 2 Adernergic Agonist

Question 1

What is the class of clonidine?

Answer 1

α2-Adrenergic Agonist

Question 2

What are the brand names for clonidine?

Answer 2

Catapres, Kapvay

Question 3

Dosage forms for clonidine?

Answer 3

Oral tablet: 0.1mg, 0.2mg, 0.3mg
oral tablet ER: 0.1mg
Transdermal patch

Question 4

indications for clonidine?

Answer 4

ADHD children over 6yrs 0.1mg ER tab po qhs max dose 0.4 mg/day

HTN

(off label use: hot sweats, nicotine dependence and spasticity)

Question 5

Clondine MOA?

Answer 5

Clonidine stimulates presynaptic α2-adrenergic receptors and blocks postsynaptic α2-adrenergic receptors in the CNS by activating inhibitory neurons to decrease sympathetic outflow. Clonidine is not a complete agonist, so some of its effects might result from antagonist actions at presynaptic α-receptors. These actions reduce peripheral vascular resistance, renal vascular resistance, HR, and BP.

Question 6

Contraindication?

Answer 6

hypersensitivity

Question 7

Clonidine Common ADR?

Answer 7

feeling nervous, headache, somnolence, erythema (patchy redness), dry mouth

Question 8

Clonidine Less Common ADR?

Answer 8

Bradycardia, constipation, contact dermatitis (patch), fatigue, hypotension, increased body temperature, irritability, nausea, palpitations, rash, rebound HTN, sedation, tachycardia, urticaria (welts/hives)

Question 9

Clonidine Serious ADR?

Answer 9

AV Block (where the electrical signal that control your heartbeat is partially blocked or completely blocked)

Question 10

Clonidine Monitoring?

Answer 10

Efficacy: decreased BP or improvement of mental and behavioral symptoms of ADHD

Toxicity: Rebound HTN, Increased HR, palpitations, syncope

Question 11

Clonidine Key patient counseling points?

Answer 11

Avoid alcohol, CNS depressants. Use caution with driving and other tasks requiring alertness. May cause nausea, vomiting, insomnia, constipation, fatigue, or dry mouth. Swallow extended-release tablet whole. Apply patch to hairless area of intact skin on upper outer arm or chest; rotate patch location. If patch loosens during the 7-d wearing, secure adhesive cover. Report signs/symptoms of hypotension, exacerbation of angina peripheral edema, fatigue, hypotension, or hepatic dysfunction with initial dosing and dose changes. Avoid abrupt discontinuation to avoid rebound HTN.

**safety and efficacy of immediate release tablet of the treatment of HTN in children is not established. ER and immediate-release are not interchangeable