Clonidine + Hydrochlorothiazide Pharmacology

Clonidine + Hydrochlorothiazide

About Clonidine + Hydrochlorothiazide
N/A
Mechanism of Action of Clonidine + Hydrochlorothiazide
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Pharmacokinets of Clonidine + Hydrochlorothiazide
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Onset of Action for Clonidine + Hydrochlorothiazide
N/A
Duration of Action for Clonidine + Hydrochlorothiazide
N/A
Half Life of Clonidine + Hydrochlorothiazide
N/A
Side Effects of Clonidine + Hydrochlorothiazide
N/A
Contra-indications of Clonidine + Hydrochlorothiazide
N/A
Special Precautions while taking Clonidine + Hydrochlorothiazide
N/A
Pregnancy Related Information
Contraindicated; since Hydrochlorothiazide is contraindicated in pregnancy, the combination generic cannot be used in pregnancy
Old Age Related Information
N/A
Breast Feeding Related Information
Contraindicated; since Hydrochlorothiazide is contraindicated in breast feeding, the combination generic cannot be used in breast feeding mother.
Children Related Information
N/A
Indications for Clonidine + Hydrochlorothiazide
1.Hypertension
Interactions for Clonidine + Hydrochlorothiazide
N/A
Typical Dosage for Clonidine + Hydrochlorothiazide
1 tablet to be taken once daily
Schedule of Clonidine + Hydrochlorothiazide
N/A
Storage Requirements for Clonidine + Hydrochlorothiazide
N/A
Effects of Missed Dosage of Clonidine + Hydrochlorothiazide
N/A
Effects of Overdose of Clonidine + Hydrochlorothiazide
N/A

Clonidine

About Clonidine
Centrally acting Alpha2-Adrenergic Agonist, Sympatholytic Antihypertensive.
Mechanism of Action of Clonidine
Clonidine exerts its action as an antihypertensive agent by stimulating alpha-2A receptors located in regions of brain, such as the nucleus tractus solitarius.Stimulation of these alpha 2 receptors brings about a decrease in sympathetic outflow from the CNS which in turn leads to decrease in peripheral vascular resistance and blood pressure.Bradycardia is also produced by Clonidine as a result of centrally induced facilitation of vagus nerve and stimulation of cardiac prejunctional alpha 2 receptors. Decrease in cardiac out put is due to decrease in stroke volume and bradycardia.
Clonidine has also been used in the prophylactic treatment of migraine or recurrent vascular headaches

Pharmacokinets of Clonidine
Absorption: Well absorbed orally, Distribution: Widely distributed,
Metabolism: Metabolized in liver, Excretion: Excreted mainly through urine.
Onset of Action for Clonidine
24 to 72 hours
Duration of Action for Clonidine
Few days
Half Life of Clonidine
12 hours
Side Effects of Clonidine
1.Sedation
2.Mental depression
3.Dryness of mouth, eyes & nose
4.Constipation
5.Impotence
6.Dizziness
7.Insomnia
8.Nightmares
9.Electrolyte imbalance
10.Bradycardia
11.Withdrawal syndrome
12.Rash
13.Urticaria
Contra-indications of Clonidine
1.Hypersensitivity to the drug
2.Sick sinus syndrome
3.Disorders of SA node activity and conduction
Special Precautions while taking Clonidine
1.Coronary disorders
2.Myocardial infarction
3.Cerebrovascular diseases
4.Renal impairment
5.Hepatic impairment
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
Indications for Clonidine
1.Hypertension
2.Menopausal symptoms
3.Opiate withdrawal
4.Nicotine withdrawal
5.Diabetic diarrhea
6.Growth delay in children
7.Alcohol withdrawal
8.Migraine prophylaxis
9.As a diagnostic agent in pheochromocytoma
Interactions for Clonidine
N/A
Typical Dosage for Clonidine
Adult
Hypertension: 100 to 200mcg/day orally 12th hourly,Increase if required to600mcg/day,Maximum dose: 2.4 mg/day
Menopausal symptoms:25 to 75 mcg orally 12hourly
Opiate withdrawal: 0.005mg to 0.017mg/kg/day in divided doses for 10 days
Nicotine withdrawal:Starts with 150mcg and increased up to 400mcg orally
Diabetic diarrhea: 150 to 1200mcg/day orally
Migraine prophylaxis:25mcg to 75mcg twice daily
Children: 0.005 to 0.025mg/kg/day
Schedule of Clonidine
H
Storage Requirements for Clonidine
Store at room temperature.Protect from heat and light.Keep away from children.
Effects of Missed Dosage of Clonidine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Clonidine
Treatment is supportive and symptomatic. Assure the airway and empty the stomach by gastric lavage. Administer activated charcoal. In case of transdermal patch remove it from the body

Hydrochlorothiazide

About Hydrochlorothiazide
Thiazide derivatibve, Diuretic.
Mechanism of Action of Hydrochlorothiazide
It is thiazide diuretic which exerts its action by acting at site-3(central dilating segment of early distal tubule). It binds to Na+Cl- symporter and inhibits Na+Cl- symport at the luminal membrane. It has additional carbonic anhydrase inhibitory actions in proximal tubules. It increases natriuresis, kaliuresis and diuresis. It decreases Ca2+ excretion and increases Mg2+excretion. It also has minor carbonic anhydrase inhibitory action. It also causes direct arteriolar vasodilatation and decreases total peripheral resistance. The antihypertensive actions of the drug may be attributable to depletion of sodium and subsequent reduction in plasma volume and a decrease in peripheral resistance. Decrease in peripheral resistance is due to either the loss of sodium from the arteriolar wall or a direct action on the vascular bed. It is an effective drug in edema associated with congestive heart failure.
Vertigo: Diuretics are used in vertigo in assumption that vertigo is due to endolymphatic hydrops. They reduce labyrinthine fluid pressure

Pharmacokinets of Hydrochlorothiazide
Absorption: It is absorbed after oral administration.
Metabolism: It is not metabolized in the body.
Excretion: Excreted unchanged in urine.

Onset of Action for Hydrochlorothiazide
1 to 3 hours
Duration of Action for Hydrochlorothiazide
12 to 16 hours
Half Life of Hydrochlorothiazide
5 to 15 hours
Side Effects of Hydrochlorothiazide
1. Dizziness
2. Blurred vision
3. Confusion
4. Tingling fingers
5. Dry mouth
6. Nausea
7. Diarrhoea
8. Constipation
9. Vomiting
10. Weakness
11. Hypokalaemia
12. Hyponatraemia
13. Hyperuricaemia
14. Elevated levels of glucose, calcium and lipids
15. Gastro intestinal disturbances
16. Polyuria
17. Electrolyte imbalance
18. Jaundice
19. Rashes
20. Photosensitivity
21. Fever
22. Itching
23. Myalgia
24. Muscle cramps
25. Arthralgia
26. Blood dyscrasias
27. Ototoxicity

Contra-indications of Hydrochlorothiazide
1. Hyper uricaemia
2. Hyper calcaemia
3. Renal impairment
4. Hepatic impairment
5. Anuria
6. Hypersensitivity to the drug
7. Hyper sensitivity to sulfonamides
8. Fluid and electrolyte imbalance

Special Precautions while taking Hydrochlorothiazide
1. Gout
2. Diabetes mellitus
3. Renal impairment
4. Hepatic impairment
5. Monitor and correct Fluid and electrolyte imbalance
6. Hyper parathyroidism
7. Cirrhosis

Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
May be used
Indications for Hydrochlorothiazide
1. Hypertension
2. Oedema associated with heart failure
3. Oedema due to renal and hepatic diseases
4. Diabetes insipidus
5. Idiopathic hypercalciurea.
6. Vertigo
Interactions for Hydrochlorothiazide
Cholestyramine & Colestipol: decrease absorption of hydrochlorothiazide.
Diazoxide: Additive action - may cause hyperglycemia, hyperuricaemia and hypotension.
Digitalis: Diuretics induced hypokalaemia may precipitate digitalis toxicity.
Lithium: Hydrochlorothiazide potentiates therapeutic and toxic effects by increasing its renal excretion.
Frusemide: Synergy leading to profound diuresis and greater than predicted electrolyte loss.
Non-depolarizing muscle relaxants: Diuretics induced hypokalaemia enhances efficacy.
Sulfonylureas: Efficacy decreased due to hydrochlorothiazide induced glucose intolerance.
Chlorpropamide: Hypokalaemia.
Propantheline: Bioavailability of hydrochlorothiazide increased.
Metoclopramide: Bioavailability of hydrochlorothiazide decreased.
NSAIDs: Natriuretic effect of hydrochlorothiazide decreased.
Typical Dosage for Hydrochlorothiazide
Adults:
Hypertension: 25mg once daily or in divided doses. Increased to 50mg if required; depending up on the patient`s response.
Children: 1mg/kg single daily dose.
Oedema:
Adults:
Starts with 25 to 50mg. Increased the dose until desired response is obtained.
Maximum dose: 200mg/day
Maintenance dosage: 25 to 100mg daily or on alternate days.
Children: 1mg/kg single daily dose or 1 to 3mg/kg/day in two divided doses



Schedule of Hydrochlorothiazide
G
Storage Requirements for Hydrochlorothiazide
Store at room temperature in a well closed container and protected from light.
Effects of Missed Dosage of Hydrochlorothiazide
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.
Effects of Overdose of Hydrochlorothiazide
Treatment is supportive and symptomatic. Remove drug from the body by induced emesis and gastric lavage. Monitor and assist respiratory, cardiovascular, and renal function as indicated. Monitor and support fluid and electrolyte balance.

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