Reserpine methyldopa

Pseudoephedrine (Sudafed, Novafed, Afrinol, Others) [OTC] [Decongestant/Sympothomimetic] Uses Deconge tant Action Stimulates a-adren gic rec tors w/ vasoconstriction Dose Adults. 30-60 mg PO q6—8h Peds. 4 mg/kg/24 h PO qid -1- in renal insuff Caution [C, +] Contra Poorly controlled HTN or CAD, w/MAOIs Disp Tabs, caps, Liq SE HTN, insomnia, tach, arrhythmias, nervousness, tremor Interactions T Risk of HTN crisis W/ MAOIs T effects W/BBs, sympathomimetics X effects W/TCAs -1- effect OF methyldopa, reserpine EMS Found in many OTC cough/cold pr >arations use sympathomimetics w/ caution, may T adverse effects OD May cause N/V, HTN, arrhythmias, and Szs symptomatic and supportive... 

Stone CA, Ross CA, Wenger HC, Ludden CT, Blessing JA Totaro JA, Porter CXI. Effect of a-methyl-3,4-diitydrojq henylalanine (methyldopa), reserpine and related agents on some vascular responses in the dog. JPharmacol Exp Ther( 962) 136, 80-8. 

A third study (85) enrolled 7825 hypertensive patients (55% males and 45% females) having diastoHc blood pressures (DBP) of 99—104 mm Hg (13—14 Pa) there were no placebo controls. Forty-six percent of the patients were assigned to SC antihypertensive dmg therapy, ie, step 1, chlorthaUdone step 2, reserpine [50-55-5] or methyldopa [555-30-6], and step 3, hydralazine [86-54-4]. Fifty-four percent of the patients were assigned to the usual care (UC) sources in the community. Significant reductions in DBP and in cardiovascular and noncardiovascular deaths were noted in both groups. In the SC group, deaths from ischemic heart disease increased 9%, and deaths from coronary heart disease (CHD) and acute myocardial infarctions were reduced 20 and 46%, respectively. 

Centrally acting agents (clonidine, methyldopa, and reserpine) Spironolactone a-Blockers Lipid medications Gemfibrozil Antidepressants... 

Any broad-spectrum antibiotic Antihypertensives Reserpine Guanethidine Methyldopa Guanabenz Guanadrel... 

Because of their reflex cardiac effect, vasodilators, if used alone in the treatment of hypertension, have not been a successful therapeutic tool. However, the reflex tachycardia and increase in cardiac output can be effectively blocked by the therapeutic association with a sympathetic blocker guanethidine, reserpine, methyldopa, or clonidine. More specifically, blockade of the cardiac beta-adrenergic receptors will also prevent the cardiac response to hydralazine. Thus, the therapeutic combination of hydralazine and propranolol can be successfully employed for effective blood pressure reduction(11). 

Antihypertensive Alpha methyldopa Clonidine Guanethidine Propranolol Reserpine... 

Dopamine antagonist activity is the hallmark of classical neuroleptics. The antihypertensive agents, reserpine (obsolete) and a-methyldopa, deplete neuronal stores of the amine. A common adverse effect of dopamine antagonists or depletors is parkinsonism. 

The six main drug classes used, worldwide, for blood pressure lowering treatment are diuretics, jS-blockers, calcium channel blockers (CCB), ACE inhibitors, angiotensin II (All) receptor blockers and a-adrenergic blockers. In some parts of the world, reserpine and methyldopa are also frequently used. 

The spectrum of activity of a-methyldopa (Aldomet) lies between those of the more potent agents, such as guanethidine, and the milder antihypertensives, such as reserpine. a-Methyldopa is a structural analogue of di-hydroxyphenylalanine (dopa) and differs from dopa only by the presence of a methyl group on the a-carbon of the side chain. 

Rx with methyldopa (Aldoclor) with reserpine (Chloroserp, Diaserp, Diupres) Chemical Class Sulfonamide derivative... 

Depression. Depression is our most common mental problem. One in four women and one in ten men will have a major depression during their lifetime.1095 More than 15 million people in the United States are affected by severe depression in any given year and more than 30,000 may commit suicide.1096 1097 Worldwide psychiatric problems, mostly depression, account for 28% of all disabilities.1098 The biogenic amine hypothesis states that depression results from the depletion of neurotransmitters in the areas of the brain involved in sleep, arousal, appetite, sex drive, and psychomotor activity. An excess of transmitters is proposed to give rise to the manic phase of the bipolar (manic-depressive) cycle that is sometimes observed. In support of this hypothesis is the observation that administration of reserpine precipitates depression, which may be serious in 15-20% of hypertensive patients receiving the drug. Similar effects are observed with the dopa decarboxylase inhibitor a-methyldopa... 

Depletion of peripheral amines probably accounts for much of the beneficial antihypertensive effect of reserpine, but a central component cannot be ruled out. The effects of low but clinically effective doses resemble those of centrally acting agents (eg, methyldopa) in that sympathetic reflexes remain largely intact, blood pressure is reduced in supine as well as in standing patients, and postural hypotension is mild. Reserpine readily enters the brain, and depletion of cerebral amine stores causes sedation, mental depression, and parkinsonism symptoms. 

Reversal of hypotensive effects of clonidine, reserpine, a-methyldopa, and guanethidine... 

Patients taking certain systemic medications are also more sensitive to the pressor effects of phenylephrine. In individuals taking atropine, the pressor effect of phenylephrine is augmented, and tachycardia can occur. Tricyclic antidepressants and monoamine oxidase (MAO) inhibitors also potentiate the cardiovascular effects of topical phenylephrine. The concomitant use of phenylephrine is contraindicated with these agents, even up to 21 days after cessation of MAO inhibitor therapy. Similarly, patients taking reserpine, guanethidine, or methyldopa are at increased risk for adverse pressor effects from topical phenylephrine because of denervation hypersensitivity accompanying the chemical sympathectomy. 

The drug is contraindicated in patients taking MAO inhibitors, tricyclic antidepressants, reserpine, guanethidine, or methyldopa. 

Patients taking monoamine oxidase inhibitors, anticholinergic drugs (such as tricyclic antidepressants), propranolol, reserpine, guanethidine, and methyldopa should be monitored closely if phenylephrine is used (SEDA-16, 542) (16). 

Tricyclic antidepressants reverse the hypotensive effects of postganglionic blocking agents, guanethidine, reser-pine, clonidine, and alpha-methyldopa, and the addition of a tricyclic can result in loss of blood pressure control (159,179). Sudden withdrawal of a tricyclic compound from a patient stabilized with these compounds can also result in serious hypotension. An additional reason for avoiding drugs such as reserpine, methyldopa, and... 

Then came the period of rapid growth in drug treatment of hypertension hydralazine, ganglion blocking agents, reserpine, chlorothiazides, guanethidine, and much more recently, methyldopa and pargyline. I want to keep your... 

The release of prolactin from the adenohypophysis is a centrally mediated event involving the dopaminergic neurons. Stimulation of these neurons blocks prolactin production, whereas blockade of dopaminergic function causes lactation. Chlorpromazine, which blocks dopamine receptors, reserpine, which depletes dopamine stores, and alpha-methyldopa, which forms a false transmitter such as alpha-methyldopamine, are all able to cause inappropriate lactation in a nonpregnant woman. 

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