Clonidine duration of action

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  1. FRaud Well-Known Member

    Clonidine duration of action


    In order to use Medscape, your browser must be set to accept cookies delivered by the Medscape site. Medscape uses cookies to customize the site based on the information we collect at registration. The cookies contain no personally identifiable information and have no effect once you leave the Medscape site. Usual dose range is 0.2 to 0.6 mg daily in divided doses. If transdermal patch is used, apply to area of hairless intact skin once q 7 days. Half-life of clonidine ranges from 6 to 20 hours in patients with normal renal function. b.i.d.; then increased by 0.1 per day at weekly intervals until desired response is achieved. Excretion: About 65% of a given dose is excreted in urine; 20% is excreted in feces. Initially, clonidine may stimulate peripheral alpha-adrenergic receptors, producing transient vasoconstriction. Antihypertensive action: Clonidine decreases peripheral vascular resistance by stimulating central alpha-adrenergic receptors, thus decreasing cerebral sympathetic outflow; drug also may inhibit renin release. Or, apply transdermal patch (0.2 mg/24 hours) and replace weekly for the first 2 or 3 weeks after smoking cessation. After oral administration, the antihypertensive effect lasts up to 8 hours; after transdermal application, the antihypertensive effect persists for up to 7 days. Contraindicated in patients hypersensitive to drug. Transdermal form is contraindicated in patients hypersensitive to any component of the adhesive layer.

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    Tricyclic antidepressant drugs and presumably phenothiazines and butyrophenones interfere with the action of clonidine. the duration of. Mechanism of action. Clonidine acts by stimulating the pre-synaptic alpha 2 adrenoceptors, thereby decreasing noradrenaline release from both central and. Apr 1, 2009. The onset of action takes 15 minutes, and the duration of action is 4 to 6. Clonidine should be avoided in patients with altered mental status.

    PO administration: 0.1-0.3 mg q4-6hr; increase by 0.1 mg/day to 0.15-0.75 mg/day if required; do not exceed 2.4 mg/day TD administration: 100-200 mcg/day patch q7Days; initiate 0.1-0.3 mg PO q4-6hr for first 2 days to allow for adequate drug levels Not recommended as routine treatment for hypertension (Beers criteria) Potential for orthostatic hypotension and adverse CNS effects May cause bradycardia Immediate release: Lower initial doses than for nongeriatric adult dosing, as well as gradual adjustments, are recommended Extended release: May require lower initial dose than for nongeriatric adult dosing Skin reactions; patch (15-50%) Dry mouth (40%) Somnolence (19-38%) Headache (19-29%) Fatigue (13-24%) Drowsiness (33%) Dizziness (13-16%) Hypotension, epidural (45%) Postural hypotension, epidural (32%) Anxiety (11%) Epidural clonidine is not recommended for obstetric postpartum or perioperative pain management because the risk of hemodynamic instability (eg, hypotension, bradycardia) may be unacceptable in this population Dilute product with strength of 500 mcg/m L prior to use Epidural: Hemodynamically unstable patients (risk of severe hypotension) Do not discontinue suddenly (risk of rebound hypertension) Patch: May need to remove if severe erythema and/or localized vesicle formation develop at application site or generalized rash; consult physician Severe coronary insufficiency May cause xerostomia Recent MI Cerebrovascular disease Chronic renal failure Raynaud's disease Thromboangiitis obliterans History of depression (may exacerbate depression in cancer patients) May impair ability to perform hazardous tasks Remove patch before MRI (may cause burns) Hypotension may occur; usually responsive to IV fluids and, if necessary, appropriate parenterally administered pressor agents Cardiac conduction abnormalities: Sympatholytic action may worsen sinus node dysfunction and atrioventricular (AV) block, especially if coadministered with other sympatholytic drugs Titrate slowly and monitor vital signs frequently in patients at risk for hypotension, heart block, bradycardia, syncope, cardiovascular disease, vascular disease, cerebrovascular disease or chronic renal failure; measure heart rate and blood pressure prior to initiation of therapy, following dose increases, and periodically while on therapy; avoid concomitant use of drugs with additive effects unless clinically indicated; advise patients to avoid becoming dehydrated or overheated Epidural administration may result in mild respiratory depression (usually with higher than recommended dose) Use with caution in cerebrovascular disease Avoid as first line antihypertensive in the elderly due to high risk for adverse side effects Children may be particularly susceptible to hypertensive episodes when experiencing GI illnesses that lead to vomiting Discontinue oral immediate release formulations within 4 hr of surgery; restart as soon as possible following surgery Due to different pharmacokinetic profiles, oral formulations are not interchangeable with extended release on a mg-mg basis due to different pharmacokinetic profiles Central sympatholytic via stimulation of central alpha receptors; results in reduced sympathetic outflow, causing decreased PVR, HR, BP, and renal vascular resistance; produces presynaptic and postjunctional alpha-2 adrenoreceptor analgesia by preventing pain signal transmission to brain Postsynaptic alpha2-agonist stimulation may regulate subcortical activity in the prefrontal cortex, which may regulate the area of the brain responsible for attention, emotions, and behaviors, and thereby reduces hyperactivity, distractibility, and impulsiveness The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Youn is a pharmacy practice resident at Fountain Valley Regional Hospital and Medical Center in Fountain Valley, California. Pham is assistant professor of pharmacy practice at Western University College of Pharmacy and Health Sciences, in Pomona, California. Hence, hypertensive emergency requires a rapid reduction in BP in hours using intravenous (IV) medications to prevent further organ damage. In contrast, hypertensive urgency does not have any physical findings of target-organ damage and is preferably managed with oral agents within 24 to 48 hours. To prevent further patient morbidity, it is important to initiate appropriate patient-directed therapy upon the recognition of hypertensive crisis. Patients presenting with hypertensive urgency do not mandate admission to a hospital. The treatment for hypertensive urgency requires a gradual lowering of BP. In fact, a rapid reduction may be associated with significant morbidity due to a marked reduction in perfusion that can result in ischemia or infarction.

    Clonidine duration of action

    Clonidine in Adults as a Sedative Agent in the Intensive Care Unit, Clonidine in Adults as a Sedative Agent in the Intensive Care.

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  3. Jul 7, 2011. The duration of action for clonidine, however, is variable and lasts between 6 and 24 hours. This variability makes it difficult to titrate doses.1.

    • Treatment Choices for Severe Hypertension Consultant360.
    • Pharmacist Rounds Hypertensive Crisis in the Health System.
    • Clonidine hydrochloride - Drug Summary - PDR. Net.

    Antihypertensive action Clonidine decreases peripheral vascular resistance by. Don't induce emesis because rapid onset of CNS depression can lead to. This dose provided similar pain relief and increased the analgesia duration as. The sympatholytic action of clonidine may worsen sinus node dysfunction and. This is a review of Clonidine. Introduction to Clonidine Mechanism of Action & Clinical Uses Side-Effects As always, please let us know your.

     
  4. NEW YORK (Reuters Health) - A single-dose of the antibiotic azithromycin, sold in the U. under the trade name Zithromax, is recommended as the first therapy to use against traveler’s diarrhea, particularly if it’s acquired in Thailand, researchers report in the journal Clinical Infectious Diseases. More than 85 percent of these pathogens are resistant to fluoroquinolone antibiotics, such as Levaquin (levofloxacin) or Cipro (ciprofloxacin), which are frequently prescribed for traveler’s diarrhea. military personnel stationed in Thailand, bacteria belonging to the Campylobacter family are responsible for up to 60 percent of cases of diarrhea, Dr. Tribble of the Naval Medical Research Center, Silver Spring, Maryland and colleagues note. To evaluate alternative treatments, the researchers studied 156 patients with diarrhea being treated at military field clinics in Thailand. The patients were randomly assigned to azithromycin given in a single dose or over 3 days, or to levofloxacin given for 3 days. Campylobacter organisms were isolated in 64 percent of the patients and 50 percent of these organisms were resistant to levofloxacin. Three days after treatment was started, the cure rate was 96 percent in the single-dose azithromycin patients, 85 percent for the three-dose azithromycin patients and 71 percent for those given levofloxacin. Eradication of bacteria up to 100 percent was seen with azithromycin compared with 38 percent with levofloxacin. Although azithromycin eradicated the bacteria much more rapidly, the time to complete recovery was about the same for each drug. Zithromax effective for traveler's diarrhea Reuters Common Side Effects of Zithromax Azithromycin Drug Center - RxList Zithromax Side Effects in Detail -
     
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    500 mg PO once, then 250 mg once daily for 4 days 2 g extended release suspension PO once 500 mg IV as single dose for at least 2 days; follow with oral therapy with single dose of 500 mg to complete 7-10 days course of therapy Infection of pharynx, cervix, urethra, or rectum: Ceftriaxone 250 mg IM once plus azithromycin 1 g PO once (preferred) or alternatively doxycycline 100 mg PO q12hr for 7 days CDC STD guidelines: MMWR Recomm Rep. June 5, 20(RR3);1-137 Agitation Allergic reaction Anemia Anorexia Candidiasis Chest pain Conjunctivitis Constipation Dermatitis (fungal) Dizziness Eczema Edema Enteritis Facial edema Fatigue Gastritis Headache Hyperkinesia Hypotension Increased cough Insomnia Leukopenia Malaise Melena Mucositis Nervousness Oral candidiasis Pain Palpitations Pharyngitis Pleural effusion Pruritus Pseudomembranous colitis Rash Rhinitis Seizures Somnolence Urticaria Vertigo Anaphylaxis Angioedema Anorexia Bronchospasm Constipation Dermatologic reactions Dyspepsia Elevated liver enzymes Erythema multiforme Flatulence Oral candidiasis Pancreatitis Pseudomembranous colitis Pyloric stenosis, rare reports of tongue discoloration Stevens-Johnson syndrome Torsades de pointes Toxic epidermal necrolysis Vomiting/diarrhea, rarely resulting in dehydration Neutropenia Elevated bilirubin, AST, ALT, BUN, creatinine Alterations in potassium Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Use with caution in abnormal liver function, hepatitis, cholestatic jaundice, hepatic necrosis, and hepatic failure have been reported, some of which have resulted in death; discontinue azithromycin immediately if signs and symptoms of hepatitis occur Injection-site reactions can occur with IV route In treatment of gonorrhea or syphilis, perform susceptibility culture tests before initiating azithromycin therapy; may mask or delay symptoms of incubating gonorrhea or syphilis. Bacterial or fungal superinfection may result from prolonged use Prolonged QT interval: Cases of torsades de pointes have been reported during postmarketing surveillance; use with caution in patients with known QT prolongation, history of torsades de pointes, congenital long QT syndrome, bradyarrhythmias, or uncompensated heart failure; also use with caution if coadministering with drugs that prolong QT interval or proarrhythmic conditions (eg, hypokalemia, hypomagnesemia); elderly patients may be more susceptible to drug-associated effects on QT interval Pneumonia: PO azithromycin is safe and effective only for community-acquired pneumonia (CAP) due to C pneumoniae, H influenzae, M pneumoniae, or S pneumoniae Cases of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) reported; despite successful symptomatic treatment of allergic symptoms, when symptomatic therapy was discontinued, allergic symptoms recurred soon thereafter in some patients without further azithromycin exposure; if allergic reaction occurs, the drug should be discontinued and appropriate therapy instituted; physicians should be aware that allergic symptoms may reappear when symptomatic therapy discontinued Endocarditis prophylaxis: Indicated only for high-risk patients, per current AHA guidelines Use caution in renal impairment (Cr Cl Because of the low levels of azithromycin in breastmilk and use in infants in higher doses, it would not be expected to cause adverse effects in breastfed infants (Lact Med; https://nih.gov/newtoxnet/lactmed.htm) Binds to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl t RNA from ribosomes, causing RNA-dependent protein synthesis to arrest; does not affect nucleic acid synthesis Concentrates in phagocytes and fibroblasts, as demonstrated by in vitro incubation techniques; in vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues Y-site: Amikacin, aztreonam, cefotaxime, ceftazidime, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, droperidol, famotidine, fentanyl, furosemide, gentamicin, imipenem, cilastatin, ketorolac, levofloxacin, morphine, piperacillin-tazobactam, ondansetron(? ), potassium chloride, ticarcillin-clavulanate, tobramycin The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. Zithromax - Pfizer Zithromax how supplied - Bethpage Consultants ZITHROMAX INJECTION Dosage & Rx Info -
     
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