Clonidine-induced hypertension in a patient with a spinal lesion
| Autor: | Karen A Gibbs, Steven L. Clause, Darren M. Triller, Angel L Backo |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Diastole Hemodynamics Pain Blood Pressure Fructose 030226 pharmacology & pharmacy Clonidine Central nervous system disease Lesion 03 medical and health sciences Orthostatic vital signs 0302 clinical medicine Topiramate Medicine Humans Pharmacology (medical) 030212 general & internal medicine Adverse effect Spinal Cord Injuries Pain Measurement Paraplegia business.industry medicine.disease Blood pressure Neuroprotective Agents Anesthesia Chronic Disease Hypertension medicine.symptom business Adrenergic alpha-Agonists medicine.drug |
| Zdroj: | The Annals of pharmacotherapy. 36(9) |
| ISSN: | 1060-0280 |
| Popis: | OBJECTIVE: To report a case of possible clonidine-induced hypertension (by Naranjo score) in a patient with a C4 spinal lesion. BACKGROUND: Clonidine is a medication long used to treat hypertension, and it is still used in the treatment of refractory hypertension. Although effective, clonidine use is hindered by adverse effects and its dual mechanism of action. CASE SUMMARY: A 39-year-old white, quadriplegic man with poorly controlled pain displayed many characteristics consistent with autonomic dysfunction (e.g., C4 spinal lesion, orthostatic hypotension, hypertension). The patient was routinely receiving transdermal clonidine and also received transdermal nitroglycerin paste as needed for control of acute hypertensive episodes. On the recommendation of the home healthcare pharmacists, clonidine was discontinued. Since that time, the patient's blood pressure and the use of emergent antihypertensive treatment have decreased significantly (maximum systolic and diastolic BP by ∼50 and 25 mm Hg, respectively). CONCLUSIONS: Many of the characteristics of autonomic dysfunction, such as refractory hypertension, can seem selective for the use of clonidine and, because of its reliance on central α2-activity for its hypotensive effects, clonidine may induce hypertension in patients with autonomic dysfunction. Clonidine should be used with great caution when autonomic dysfunction is suspected. |
| Databáze: | OpenAIRE |
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