guanfacine

Question 1

Main cautions for guanfacine - TDP

Answer 1

caution with
Bradycardia (risk TDP)
Heart block (risk TDP)
History CVD
History QT interval prolongation
Hypokalaemia (risk TDP)

Question 2

Main interactions are to do with (2)

Answer 2

bradycardia
hypotension

Question 3

Info re somnolence and sedation

Answer 3

Somnolence and sedation may occur, predominantly during the first 2-3 weeks of treatment and with dose increases; manufacturer advises to consider dose reduction or discontinuation of treatment if symptoms are clinically significant or persistent.

Question 4

Signs of overdose

Answer 4

hypotension, initial hypertension, bradycardia, lethargy, and respiratory depression
patients who develop lethargy should be observed for development of more serious toxicity for up to 24 hours

Question 5

Contraception needed?

Answer 5

effective contraception in females of childbearing potential.

Question 6

Monitoring

Answer 6

• baseline test to identify if at risk of somnolence, sedation, hypotension, bradycardia, QT prolong, arrhythmia
• include assessment of CV status
• monitor for signs of these adverse effect weekly during dose titration and then every 3 months for first year, then every 6 motnhs
• monitor BMI before treatmentt, then every 3 months for 1 year, then every 6 months
• more frequent monitoring advised following dose adjusmnets
• monitor BP and pulse during dose downward titration and following discontinuation

Question 7

True of false - you need to measure BMI after treatment

Answer 7

false
take BMI before, then every 3 months for 1 year, then every 6 months

Question 8

True or false - you need to monitor BP and pulse regularly in pt taking guanfacine

Answer 8

False - monitor these during dose downward titration and following discontinuation of treatment

Question 9

True or false - unlike the amphetamines and atomoxetine, you can abruptly withdraw

Answer 9

False - avoid abrupt withdrawal; consider dose tapering to minimise potential withdrawal effects.

Question 10

Is there any special directions for administration for guanfacine?

Answer 10

Manufacturer advises avoid administration with high fat meals (may increase absorption).

Question 11

Labels

Answer 11

Warning: This medicine may make you sleepy. If this happens, do not drive or use tools or machines. Do not drink alcohol.
Swallow this medicine whole. Do not chew or crush.