Drowsiness methyldopa

Methyldopa is effective in mild, moderate, and severe hypertension but a thiazide-type diuretic is needed to overcome the fluid retaining side effect. Methyldopa has been shown to prevent and induce regression of ventricular hypertrophy in hypertensive patients. The principal side effects are sedation, drowsiness, nasal congestion, fluid retention, and in rare occasions, hemolytic anemia. 

The most commonly encountered side effects of a-methyldopa are sedation and drowsiness. These CNS effects are probably the result of reductions in brain catecholamine levels. Other side effects, also typical of sympathetic depression, are dry mouth, nasal congestion, orthostatic hypertension, and impotence. 

Other medications, which will not be discussed in the following chapters, have psychotropic actions that are considered to be side effects or adverse effects. Thus, some antihistamines (Le. products used to counteract allergic reactions) induce fatigue and drowsiness, and the same applies to some myorelaxants. Older antihypertensives (Le. agents reducing blood pressure) such as alpha-methyldopa (Aldomet ) or clonidine (Catapres 1) can cause fatigue and depression. 

Methyldopa [Aldomet) [Antihypertensive/Centrally Acting Antiadrenergic] Uses HTN Action Centrally acting antihypertensive Dose Adults. 250-500 mg PO bid-dd (max 2-3 g/d) or 250 mg-1 g IV q6-8h Peds. 10 mg/kg/24 h PO in 2-3 + doses (max 40 mg/kg/24 h - q6-l2h) or 5-10 mg/kg/dose IV q6-8h to total dose of 20—40 mg/kg/24 h i in renal insuff/elderly Caution [B (PO), C (IV), +] Contra Liver Dz MAOIs Disp Tabs, inj SE Discolors urine inidal transient sedadon/drowsiness frequent, edema, hemolydc anemia, hepadc disorders Interactions T Effects W/ anesthetics, diuredcs, levodopa, Li, methotrimeprazine, thioxanthenes, vasodilators, verapamil T effects OF haloperidol, Li, tolbutamide 1 effects W7amphetamines, Fe, phenothiazine, TCAs 1 effects OF ephedrine EMS Use diuredcs, verapamil, and sympathomimedcs w/ caudon may T risk hypotension, arrhythmias and pressors effects OD May cause profound hypotension, drowsiness, and impaired myocardial conduction activated charcoal may be effective... 

This a2-agonist is converted to methylnorepinephrine centrally to diminish the adrenergic outflow from the CNS, leading to reduced total peripheral resistance and a decreased blood pressure. Cardiac output is not decreased and blood flow to vital organs is not diminished. Because blood flow to the kidney is not diminished by its use, a-methyldopa [meth ill DOE pa] is especially valuable in treating hypertensive patients with renal insufficiency. The most common side effects of a-methyldopa are sedation and drowsiness. 

An advantage of clonidine is the absence of orthostatic hypotension, but like a-methyldopa and reserpine it may cause drowsiness, and marked sedation occurs in up to 50% of patients treated in some series. Sedation can be so severe as to proceed to semi-consciousness. Nightmares and delusions are another expression of the drug s influence upon the central nervous system. Apart from sedation, the complaint of dry mouth and nose is the most common side effect recorded with clonidine administration. Dizziness, headache and fatigue are frequently mentioned, as well as anorexia, nausea, constipation and even pseudo-obstruction (94 ), anxiety, depression, drug fever and rashes. Side effects occur in 50—70% of the patients treated and are in some 20% the reason for discontinuation of therapy (3 , 13, 83 ). 

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