Clonidine

Question 1

Alternate Name / Cost

Answer 1

Catapres, methyldopa -> Cost 4-37$ to 108 (Catapres)

Question 2

Drug Class

Answer 2

Pharm: Central alpha2 agonist

Therapeutic Class: Antihypertensive, adjunct to Rx of opioid withdrawal, prophylaxis of migraine

Question 3

Pharmacodynamics

Answer 3

Stimulates alpha2 adrenoceptors in brainstem, thereby leading to down regulation of sympathetic output

Question 4

Pharmacokinetics

Answer 4

Onset 1 hr, duration, 8 hr, F~85%, also available as cutaneous patch

Question 5

Toxicity

Answer 5

Withdraw gradually because of risk of rebound HTN; risk of bradycardia in sinus node disease; lethargy, fatigue, depression

Question 6

Interactions

Answer 6

Additive effects with most other antihypertensives; additive sedation with other CNS drugs, side effect sedation (arousal / wakefullness) therefore do not give to patients that cannot fall asleep

Question 7

Special considerations

Answer 7

Pregancy class C; avoid in patients with renal insufficiency

Question 8

Indications and Dose / Route

Answer 8

Begin with 0.1 mg po bid, up to 1.2 mg per day; transdermal begin with 0.1 mg per 24 hr as a 7 day patch

Question 9

Monitor

Answer 9

Follow BP and HR, fatigue