Reserpine diarrhea with

In comparison with more modem antihypertensives reserpine causes unpleasant side-effects, such as sedation, depression and various effects reflecting a dominant parasympathetic system (nasal congestion, diarrhea and exacerbation of peptic ulcers). Reserpine should be considered as an antihypertensive of second choice, although in certain countries it is still used because of its low price. 

Reserpine rather often produces mild diarrhea and gastrointestinal cramps and increases gastric acid secretion. The drug should not be given to patients with a history of peptic ulcer. 

Reserpine depletes cerebral dopamine by preventing intraneuronal storage (see Chapter 6) it is introduced in low doses (eg, 0.25 mg daily), and the daily dose is then built up gradually (eg, by 0.25 mg every week) until benefit occurs or adverse effects become troublesome. A daily dose of 2-5 mg is often effective in suppressing abnormal movements, but adverse effects may include hypotension, depression, sedation, diarrhea, and nasal congestion. Tetrabenazine (12.5-50 mg orally three times daily) resembles reserpine in depleting cerebral dopamine and has less troublesome adverse effects it is now available in the USA. Treatment with postsynaptic dopamine receptor blockers such as phenothiazines and... 

Contraindications Usually safe if not taken in overdoses or excessively. Too much, or in sensitive individuals, may case nasal stuffiness, diarrhea, slowed heartbeat, drowsiness, fatigue. Too frequent use may cause weight gain. MAO inhibitions interefere with serotonin- and norepinephrine-depleting action of reserpine. 

Pharmacological evaluation of the ethers and their water-soluble salts revealed a marked sedative action in dogs without any demonstrable antihypertensive effect. The tranquilizing activity differs from that of reserpine in that its onset occurs within minutes rather than hours and the duration of action is considerably shorter than that of reserpine. Cumulation is not evident on repeated administration there is no effect on the gastrointestinal tract and no diarrhea occurs (182). Clinically, the normal, as well as the 18-epi, ethers were found to be effective when given to patients with mild or moderate anxiety. However, the tranquilizing activity of the normal ethers is considerably higher, and for all practical purposes the 18-epi ethers are not suitable for human therapy. 

The side-effects of reserpine include hypotension, bradycardia and increased gastrointestinal motility and diarrhea (Lloyd et al 1985), all resulting from decreased sympathetic tone and increased parasympathetic tone. The hypotensive effects of reserpine may take days to several weeks to occur but may persist for 1 to 6 weeks after the withdrawal of the dmg. Administration of induction agents, such as xylazine and ketamine, that produce hypotension may be fatal in horses treated with reserpine. 

Reserpine (e.g., Sandril) Depletes catecholamines and serotonin in brain, adrenal, and heart. Inhibits uptake of norepinephrine into presynaptic vesicles. Chronically sensitizes patient to sympathomimetics. Gradual 4 mean arterial pressure with bradycardia. Antihypertensive effects due to 4 cardiac output. Tranquilization, sedation. Nightmares, depression, diarrhea, cramps, T risk of breast cancer, peptic ulcers, parasympathetic predominance. 

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