Drug Study

Name of Drug Mechanism of Indication Contraindication Side Effects Nursing Responsibility

Action
Generic Name: Action: Therapeutic Contraindicated in CNS: drowsiness, Assessment
Clonidine Stimulates alpha- outcome: Hypertensitivity, depression, Monitor intake and
(Klon-i-deen) adrenergic receptors PO, Transdermal: Epidural-injection dizziness, output ratios and daily
in the CNS; which management of mild site: infection, nervousness, weight, and assess for
Brand Name: results in decreased to moderate anticoagulant nightmares. edema daily,
Catapres, Catapres- sympathetic outflow hypertension therapy, or bleeding especially at
TTS, Dixarit, inhibiting problems. CV: bradycardia, beginning of therapy.
Duraclon cardioacceleration Epidural: hypotension Monitor blood
and vasoconstriction Management of (increased with pressure and pulse
Functional class: centers. cancer pain Precautions: epidural), frequently during
Antihypertensives unresponsive to Serious cardiac or palpitations. initial dosage
Prevents pain signal opioids alone. cerebrovascular adjustment and
Chemical class: transmission to the disease, renal GI: dry mouth, periodically
Adrenergics (centrally CNS by stimulating Unlabeled uses: insufficiency, constipation, nausea, throughout therapy.
acting) alpha-adrenergic Management of geriatric patients vomiting. Report significant
receptors in the spinal opioid withdrawal (dosage reduction changes.
Pregnancy category: cord. may be required), GU: impotence Pain: assess location,
C pregnancy or character, and
Decreased blood lactation (safety not INTEG: rash, intensity of pain prior
Dosage and routes: pressure. established) sweating. to, frequently during
Oral: PO: Adults: first few days, and
Hypetension (initial Decreased pain. FLUIDS AND routinely throughout
dose) 100mcg ELECTROLYTES: administration.
(0.1mg) BID, increase Sodium retention Monitor for fever as
by 100-200mcg (0.1- potential sign of
0.2mg)/day q2 to 4 METAB: weight catheter infection.
days gain Opioid withdrawal:
. Monitor patient for
Others: withdrawal signs and symptoms
phenomenon of opioid withdrawal
(tachycardia, fever,
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runny nose, diarrhea,

sweating, nausea,
vomiting, irritability,
stomach cramps,
shivering, unusually
large pupils,
weakness, difficulty
sleeping, gooseflesh)
Lab test
considerations: may
cause transient
increase in blood
glucose levels. May
cause decreased
urinary catecholamine
and vanillylmandelic
acid concentration;
these may increase on
abrupt withdrawal.
May cause weakly
positive coombs test
result.

Nursing Diagnosis
Acute pain
Rise for injury

Implementation
In the perioperative
setting, continue
clonidine up to 4hours
prior to surgery and
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resume as soon as
possible thereafter.
Do not interrupt
transdermal clonidine
during surgery.
Monitor blood
pressure carefully.
PO: administer last
dose of the day at
bedtime.
Transdermal:
Transdermal system
should be applied
once every 7 days.
May be applied to any
hairless site;avoid
cuts or calluses.
Absorption is greater
when placed on chest
or upper arm and
decreased when
placed on thigh.
Rotate sites. Wash
area with soap and
water; dry thoroughly
before application.
Apply firm pressure
over patch to ensure
contact with skin,
especially around
edges. Remove old
system and discard.
System includes a
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protective adhesive
overlay to be applied
over medication patch
to ensure adhesion,
should medication
patch loosen.

Patient/family education
Instruct patient to take
clonidine at the same
time each day, even if
feeling well. If a dose
is missed, take as
soon as remembered.
If more than 1 oral
dose in a row missed
of if transdermal
system is low in being
changed by 3 or more
days, contact health
professional. All
routes of clonidine
should be gradually
discontinued over 2 to
4 days to prevent
rebound hypertensive.
Advise patient to
make sure enough
medication is
available for
weekends, holidays,
and vacations. A
written prescription
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may be kept in wallet

in case of emergency.
Clonidine may cause
drowsiness, which
normally diminishes
with continued use.
Advise patient to
avoid driving or other
activities requiring
alertness until
response to
medication is known.
Caution patient to
avoid sudden changes
in position to decrease
orthostatic
hypertension. Use of
alcohol, standing for
long periods,
exercising and hot
weather may increase
orthostatic
hypotension.
If dry mouth occurs,
frequent mouth rinses,
good oral hygiene,
and sugarless gum or
candy may decrease
effect. If dry mouth
continues for more
than 2 weeks, consult
health care
professional.
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Hypertension:
encourage patient to
comply with
additional
interventions for
hypertension (weight
reduction, low-
sodium diet,
discontinuation of
smoking, moderation
of alcohol
consumption, regular
exercise, and stress
management)

Evaluation
Effectiveness of therapy
can be demonstrated by:
Decrease in blood
pressure
Decrease severity of
pain
Decrease in the
signs and symptoms
of opioid withdrawal