The Fourth Lilly Prize Lecture, University of Aberdeen, September 1980. The clinical pharmacology of clonidine and related central antihypertensive agents.

Reid, JL

doi:10.1111/j.1365-2125.1981.tb01217.x

Cited by 61 publications

(4 citation statements)

References 38 publications

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“…[ 4 ] Previous studies have reported a reduction in core temperature during transurethral prostatectomy. [ 6 11 13 14 15 ] The cardiovascular system is stressed as a result of increased afterload, effects on myocardial excitability and conduction and the metabolic demands of rewarming. [ 4 ] The metabolic cost of shivering is an increase in oxygen consumption from 300% to 800%, respectively.…”

Section: Discussionmentioning

confidence: 99%

A comparative study evaluating the prophylactic efficacy of oral clonidine and tramadol for perioperative shivering in geriatric patients undergoing transurethral resection of prostate

Tewari

Dhawan

Mahendru

et al. 2014

J Anaesthesiol Clin Pharmacol

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Background and Aims:Perioperative shivering, in geriatric patients undergoing urological surgery under central neuraxial blockade is a common complication. Prophylactic measures to reduce shivering are quintessential to decrease the morbidity and mortality. Believing that oral formulation will bring down the cost of treatment, we decided to compare the efficacy of oral clonidine and tramadol, as premedication, in prevention of shivering in patients undergoing transurethral resection of prostate (TURP) under spinal anesthesia in a prospective and double-blind manner.Materials and Methods:The patients were randomly allocated into three groups (40 patients each). Group I received oral clonidine 150 μg, Group II received oral tramadol 50 mg, while Group III received a placebo. Number of patients having shivering, their grades and duration, hemodynamic changes, and side-effects in the form of sedation were recorded. Data were analyzed using analysis of variance, Student's t-test, Z test as and when appropriate.Results:In group I and II, 38 patients (95%) and 37 patients (92.5%) did not shiver, respectively. Although in the group III, 24 patients (60%) exhibited no grade of shivering, the shivering was of significantly severe intensity and lasted for a longer duration. No, clinically significant collateral effects were observed in patients who were administered clonidine or tramadol.Conclusions:Oral clonidine and tramadol were comparable in respect to their effect in decreasing the incidence, intensity, and duration of shivering when used prophylactically in patients who underwent TURP under subarachnoid blockade.

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Section: Discussionmentioning

confidence: 99%

A comparative study evaluating the prophylactic efficacy of oral clonidine and tramadol for perioperative shivering in geriatric patients undergoing transurethral resection of prostate

Tewari

Dhawan

Mahendru

et al. 2014

J Anaesthesiol Clin Pharmacol

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“…Administration was conducted 60 min before the trauma film, since peak plasma levels of oral clonidine occur after 60–90 min with an elimination half-life of about 6 to 12 h (Reid, 1981) and oral yohimbine peaks in plasma after 45–60 min with an elimination half-life of about 0.60 ( s.d. = 0.25) h (Owen et al 1987).…”

Section: Methodsmentioning

confidence: 99%

Influence of the noradrenergic system on the formation of intrusive memories in women: an experimental approach with a trauma film paradigm

et al. 2016

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“…Clonidine is well absorbed orally, with oral bioavailability ranging from 75 to 90 % within 30-60 min; pharmacokinetics may be altered with chronic administration [105][106][107]. Peak plasma concentrations are reached in 1-3 h, and the terminal half-life averages 9 h [108].…”

Section: Pharmacokineticsmentioning

confidence: 99%

Overdose of Drugs for Attention-Deficit Hyperactivity Disorder: Clinical Presentation, Mechanisms of Toxicity, and Management

2013

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The prevalence of attention-deficit hyperactivity disorder (ADHD) in the USA is estimated at approximately 4-9% in children and 4% in adults. It is estimated that prescriptions for ADHD medications are written for more than 2.7 million children per year. In 2010, US poison centers reported 17,000 human exposures to ADHD medications, with 80% occurring in children <19 years old and 20% in adults. The drugs used for the treatment of ADHD are diverse but can be roughly separated into two groups: the stimulants such as amphetamine, methylphenidate, and modafinil; and the non-stimulants such as atomoxetine, guanfacine, and clonidine. This review focuses on mechanisms of toxicity after overdose with ADHD medications, clinical effects from overdose, and management. Amphetamine, dextroamphetamine, and methylphenidate act as substrates for the cellular monoamine transporter, especially the dopamine transporter (DAT) and less so the norepinephrine (NET) and serotonin transporter. The mechanism of toxicity is primarily related to excessive extracellular dopamine, norepinephrine, and serotonin. The primary clinical syndrome involves prominent neurological and cardiovascular effects, but secondary complications can involve renal, muscle, pulmonary, and gastrointestinal (GI) effects. In overdose, the patient may present with mydriasis, tremor, agitation, hyperreflexia, combative behavior, confusion, hallucinations, delirium, anxiety, paranoia, movement disorders, and seizures. The management of amphetamine, dextroamphetamine, and methylphenidate overdose is largely supportive, with a focus on interruption of the sympathomimetic syndrome with judicious use of benzodiazepines. In cases where agitation, delirium, and movement disorders are unresponsive to benzodiazepines, second-line therapies include antipsychotics such as ziprasidone or haloperidol, central alpha-adrenoreceptor agonists such as dexmedetomidine, or propofol. Modafinil is not US FDA approved for treatment of ADHD; however, it has been shown to improve ADHD signs and symptoms and has been used as an off-label pharmaceutical for this diagnosis in both adults and children. The mechanism of action of modafinil is complex and not fully understood. It is known to cause an increase in extracellular concentrations of dopamine, norepinephrine, and serotonin in the neocortex. Overdose with modafinil is generally of moderate severity, with reported ingestions of doses up to 8 g. The most common neurological effects include increased anxiety, agitation, headache, dizziness, insomnia, tremors, and dystonia. The management of modafinil overdose is largely supportive, with a focus on sedation, and control of dyskinesias and blood pressure. Atomoxetine is a selective presynaptic norepinephrine transporter inhibitor. The clinical presentation after overdose with atomoxetine has generally been mild. The primary effects have been drowsiness, agitation, hyperactivity, GI upset, tremor, hyperreflexia, tachycardia hypertension, and seizure. The management of atomoxetine overdose is la...

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The Fourth Lilly Prize Lecture, University of Aberdeen, September 1980. The clinical pharmacology of clonidine and related central antihypertensive agents.

Cited by 61 publications

References 38 publications

A comparative study evaluating the prophylactic efficacy of oral clonidine and tramadol for perioperative shivering in geriatric patients undergoing transurethral resection of prostate

A comparative study evaluating the prophylactic efficacy of oral clonidine and tramadol for perioperative shivering in geriatric patients undergoing transurethral resection of prostate

Influence of the noradrenergic system on the formation of intrusive memories in women: an experimental approach with a trauma film paradigm

Overdose of Drugs for Attention-Deficit Hyperactivity Disorder: Clinical Presentation, Mechanisms of Toxicity, and Management

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