Antihypertensives Local anaesthetics

ANAESTHETICS - LOCAL ANTIHYPERTENSIVES AND HEART FAILURE DRUGS ... 

Tricyclic antidepressants potentiate the pressor effects of directly acting sympathomimetic amines, such as adrenaline (epinephrine) or noradrenaline (norepinephrine), to cause hypertension. Small amounts of these, such as may be present in local anaesthetic solutions, can be dangerous. Tricyclic antidepressants will inhibit the antihypertensive effects of the older anti hypertensive drugs, such as adrenergic neurone-blocking agents, e.g. guanethidine, a-methyl-DOPA, and clonidine. 

Feldene piroxicam. felodipine [ban, inn, usan] (Plendil etc.) is a dihydropyridine calcium-channel blocker with VASODILATOR properties, which can be used in ANTIHYPERTENSIVE therapy and antianginal prophylaxis, felypressin [ban, inn, usan] ([Phe Lys ]vasopressin phelypressin PLV2 Octapressin Octopressin ) is a synthetic analogue of vasopressin. It is a VASOCONSTRICTOR and is incorporated into LOCAL ANAESTHETIC preparations to prolong their duration of action. (It is a constituent with prilocaine of Citanest with Octapressin .)... 

Accidental intravenous administration of local anaesthetics during spinal anaesthesia may cause cardiovascular collapse and, on theoretical grounds, the serious cardiac depressant effects could be enhanced in patients taking antihypertensives, especially elderly patients with impaired cardiovascular function. Particular care would seem to be important with any patient given epidural anaesthesia while taking antihypertensives. 

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