CAAA's-ATI Pharm

Question 1

CAAA’s stand for

Answer 1

Centrally acting alpha antagonists

Question 2

Meds

Answer 2

Prototype=Clonidine

• guanfacine
• methyldopa

Question 3

Expected pharm action

Answer 3

Act within CNS to decreases sympathetic outflow resulting in decreased stimulation of the andrenergic receptors(alpha and beta) of the heart and peripheral vascular system

• decrease in sympathetic outflow to myocardium results in bradycardia and decreased cardiac output(CO)
• decrease in sympathetic outflow to peripheral vasculature results in vasodilation, which leads to decreased BP

Question 4

Therapeutic uses

Answer 4

1-primary hypertension(alone or in combo w/diuretic or another antihypertensive agent
2-severe cancer pain(parenterally by epidural infusion)
Investigational=
1-migraines,2-menopause flushing,3-ADHD/tourettes,4-withdrawal from alcohol,tobacco,opioids

Question 5

Complications

Answer 5

1-drowsiness&sedation
2-dry mouth(resolves in 2-4 wks)
3-rebound hypertension if abruptly discontinued=don’t discontinue w/o talking to provider,discontinue clonidine gradually over 2 to 4 days

Question 6

Contraindications/precautions

Answer 6

Pregnancy Risk Cat
Clonidine=C;Methyldopa/Guanfacine=B
1-avoid use during lactation
2-avoid use of transdermal patch on affected skin in scleroderma/lupus
-Contraindicated in pts who have bleeding disorder/on anticoagulants
-use caution on pts who have had a stroke,asthma,COPD,recent MI,diabetes,major depressive disorder or chronic kidney disease

Question 7

Interactions

Answer 7

1-antihypertensive meds=additive effect
2-Prazosin/MAOI’s,tricyclic antidepressants=can counteract antihypertensive effect of Clonidine
3-CNS depressants such as alcohol=additive CNS depression can occur

Question 8

Nursing admin

Answer 8

1-oral,epidural,transdermal
2-twice a day in divided doses, take larger dose at bedtime
3-transdermal patches applied every 7 days on torso/upper arm