Clonidine Alcohol

Dobrydnjov I, Axelsson K, Berggren L, et al Intrathecal and oral clonidine as prophylaxis for postoperative alcohol withdrawal syndrome a randomized double-blinded study. Anesth Analg 98 738—744, 2004... 

Cheskin LJ, Fudala PJ, Johnson RE A controlled comparison of buprenorphine and clonidine for acute detoxification from opioids. Drug Alcohol Depend 36 115-121, 1994... 

Kleber HD, Weissman MM, Rounsaville BJ, et al Imipramine as treatment for depression in addicts. Arch Gen Psychiatry 40 649-633, 1983 Kleber HD, Riordan CE, Rounsaville BJ, et al Clonidine in outpatient detoxification from methadone maintenance. Arch Gen Psychiatry 42 391-394, 1983 Kleber HD, Topazian M, Gaspari J, et al Clonidine and naltrexone in the outpatient treatment of heroin withdrawal. Am J Drug Alcohol Abuse 13 1-17, 1987 Kornetsky C. Brain stimulation reward, morphine-induced stereotypy, and sensitization implications for abuse. Neurosci Biobehav Rev 27 777-786, 2004 Kosten TR, Kleber HD Buprenorphine detoxification from opioid dependence a pilot study. Life Sci 42 633-641, 1988... 

Umbricht A, Hoover DR, Tucker MJ, et al Opioid detoxification with buprenorphine, clonidine, or methadone in hospitalized heroin-dependent patients with HIV infection. Drug Alcohol Depend 69 263-272, 2003 Villagomez RE, Meyer TJ, Lin MM, et al Post-traumatic stress disorder among inner city methadone maintenance patients. Subst Abuse Treat 12 253—257, 1995 Mining E, Kosten TR, Kleber H Clinical utility of rapid clonidine-naltrexone detoxification for opioid abusers. Br J Addict 83 567-575, 1988 Washton AM, Pottash AC, Gold MS Naltrexone in addicted business executives and physicians. J Clin Psychiatry 45 39 1, 1984 Wesson DR Revival of medical maintenance in the treatment of heroin dependence (editorial). JAMA 259 3314-3315, 1988... 

Cionidine. Clonidine dampens sympathetic activity originating at the locus coeruleus by stimulation of presynaptic a2-adrenergic receptors in the sympathetic chain (Covey and Classman 1991 Hughes 1994). It appears to have some efficacy for alcohol and opioid withdrawal and thus was evaluated for treatment of nicotine withdrawal as well (Covey and Classman 1991 Hughes 1994). Several clinical trials used oral or transdermal clonidine in doses of 0.1—0.4 mg/day for 2—6 weeks with or without behavior therapy. Three meta-analytic reviews reported that clonidine improved quit rates (Covey and Classman 1991 Courlay and Benowitz 1995 Law and Tang 1995). 

Gossop M (1988) Clonidine and the treatment of the opiate withdrawal syndrome. Drug Alcohol Depend 21 253-259... 

Beta-blockers interact with a large number of other medications. The combination of beta-blockers with calcium antagonists should be avoided, given the risk for hypotension and cardiac arrhythmias. Cimetidine, hydralazine, and alcohol all increase blood levels of beta-blockers, whereas rifampicin decreases their concentrations. Beta-blockers may increase blood levels of phenothiazines and other neuroleptics, clonidine, phen-ytoin, anesthetics, lidocaine, epinephrine, monoamine oxidase inhibitors and other antidepressants, benzodiazepines, and thyroxine. Beta-blockers decrease the effects of insulin and oral hypoglycemic agents. Smoking, oral contraceptives, carbamazepine, and nonsteroidal anti-inflammatory analgesics decrease the effects of beta-blockers (Coffey, 1990). 

A rather simpler compound includes both a benzodioxan nucleus and the imidazoline function associated with a-adrenergic agonists such as clonidine. As in the standard approach for preparing imidazolines, the treatment of nitrile (60-1) with alcoholic hydrogen chloride leads to the iminoether (60-2). Reaction of that intermediate with ethylenediamine then affords idazoxin (60-3) [70], a compound that interacts with a-adrenergic receptors. 

Castells X, Casas M, Vildal X, Bosch R, Roncero C, Ramos-Quiroga JA Capella D (2007) Efficacy of central nervous system stimulant treatment for cocaine dependence a systematic review and meta-analysis of randomized controlled clinical trials. Addiction, 102, 1871-87 Chaisson RE, Bacchetti P, Osmond D, Brodie B, Sande MA Moss AR (1989). Cocaine use and HIV infection in intravenous drug users in San Francisco. Journal of the American Medical Association, 261, 561-5 Chapleo CB Walter DS (1997). The bupre-norphine-naloxone combination product. Research and Clinical Forums, 19, 55-8 Cheskin LJ, Fudala PJ Johnson RE (1994). A controlled comparison of buprenorphine and clonidine for acute detoxification from opioids. Drug and Alcohol Dependence, 36, 115-21... 

Addictive Disorders and their Treatment, 2,19-24 Lin SK, Strang J, Su LW, Tsai CJ Hu WH (1997). Double-blind randomised controlled trial of lofexidine versus clonidine in the treatment of heroin withdrawal. Drug and Alcohol Dependence, 48, 127-33 linehan MM, Dimeff LA, Reynolds SK, Comtois KA, Welch SS, Heagerty P Kivlahan DR (2002). Dialectal behavior therapy versus comprehensive validation therapy plus 12-step... 

Toxicants may have three effects on pulse rate bradycardia (decreased rate), tachycardia (increased rate), and arrhythmia (irregular pulse). Alcohols may cause either bradycardia or tachycardia. Amphetamines, belladonna alkaloids, cocaine, and tricyclic antidepressants (see imi-primine hydrochloride in Figure 6.12) may cause either tachycardia or arrhythmia. Toxic doses of digitalis may result in bradycardia or arrhythmia. The pulse rate is decreased by toxic exposure to carbamates, organophosphates, local anesthetics, barbiturates, clonidine, muscaric mushroom toxins, and opiates. In addition to the substances mentioned above, those that cause arrhythmia are arsenic, caffeine, belladonna alkaloids, phenothizine, theophylline, and some kinds of solvents. 

CENTRALLY ACTING ANTIHYPERTENSIVES ALCOHOL Clonidine and moxonidine may exacerbate the sedative effects of alcohol, particularly during initiation of therapy Uncertain Warn patients of this effect and advise them to avoid driving or operating machinery if they suffer from sedation... 

May be useful in decreasing the hypertension, tachycardia, and tremulousness associated with alcohol withdrawal, but not the seizures or delirium tremens In complicated alcohol withdrawal Clonidine may Improve social relationships, affectual responses, and sensory responses In autistic disorder Clonidine may reduce the Incidence of menopausal flushing Growth hormone response to clonidine may be reduced during menses Clonidine stimulates growth hormone secretion (no chronic effects have been observed)... 

Alcohol may reduce the effects of clonidine on growth hormone... 

When treating alcoholic liver diseases, it should be taken into account that one is generally dealing with chronic alcoholics. Therefore, one should be aware of the fact that a withrawal syndrome might occur, possibly requiring the application of clomethiazole, haloperidol or clonidine. In this complicated phase, the administration of zinc is likewise recommended. (138)... 

Alcohol and morphine a2-Agonists Central (and peripheral prejunctional) reduction Clonidine... 

Clinically important, potentially hazardous interactions with alcohol, amprenavir, arbutamine, cholestyramine, clonidine, CNS depressants, epinephrine, formoterol, guanethidine, isocarboxazid, linezolid, MAO inhibitors, phenelzine, QT interval prolonging agents, quinolones, selegiline, sparfloxacin, sympathomimetics, tranylcypromine... 

Clinically important, potentially hazardous interactions with albuterol, alcohol, clonidine, corticosteroids, danazol, diuretics, epinephrine, estrogens, isoniazid, lithium, oral contraceptives, pentamidine, phenothiazines, propranolol, somatropin, terbutaline, thyroid... 

Clinically important, potentially hazardous interactions with alcohol, amiodarone, amphotericin B, cisapride, clonidine, digitalis, diltiazem, disopyramide, erythromycin, glucocorticoids, halofantrine, haloperidol, hypokalemic diruretics, imipramine antidepressants, levodopa, lithium, pentamidine, pimozide, quinidine, sotalol, stimulant laxatives, tetracosactides, thioridazine... 

Although phenothiazines, clonidine, carbamazepine, y-hydroxybutyric acid, and valproic acid may reduce symptoms of alcohol withdrawal, their ability to prevent seizures or delirium tremens has yet to be proven, and in fact, the phenothiazines may lower the seizure threshold. Other drugs used to treat symptoms of alcohol withdrawal include other barbiturates, alcohol itself, sympatholytics such as atenolol, thiamine, magnesium, and other neuroleptics such as haloperidol. At the time of this writing, gabapentin is being compared to lorazepam for acute alcohol withdrawal in a phase II clinical trial. 

The major therapeutic use of clonidine (Catapres, others) is in the treatment of hypertension. Clonidine also has apparent efficacy in the off-label treatment of a range of other disorders. Stimulation of ot2-receptors in the G1 tract may increase absorption of sodium chloride and fluid and inhibit secretion of bicarbonate. This may explain why clonidine has been found to be useful in reducing diarrhea in some diabetic patients with autonomic neuropathy. Clonidine also is useful in treating and preparing addicted subjects for withdrawal from narcotics, alcohol, and tobacco. It may help ameliorate some of the adverse sympathetic nervous activity associated with withdrawal from these agents, as well as decrease craving for the... 

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