Document Detail

Clonidine-induced hypertension in a patient with a spinal lesion.
MedLine Citation:
PMID:  12196059     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To report a case of possible clonidine-induced hypertension (by Naranjo score) in a patient with a C4 spinal lesion.
BACKGROUND: Clonidine is a medication long used to treat hypertension, and it is still used in the treatment of refractory hypertension. Although effective, clonidine use is hindered by adverse effects and its dual mechanism of action.
CASE SUMMARY: A 39-year-old white, quadriplegic man with poorly controlled pain displayed many characteristics consistent with autonomic dysfunction (e.g., C4 spinal lesion, orthostatic hypotension, hypertension). The patient was routinely receiving transdermal clonidine and also received transdermal nitroglycerin paste as needed for control of acute hypertensive episodes. On the recommendation of the home healthcare pharmacists, clonidine was discontinued. Since that time, the patient's blood pressure and the use of emergent antihypertensive treatment have decreased significantly (maximum systolic and diastolic BP by approximately 50 and 25 mm Hg, respectively).
CONCLUSIONS: Many of the characteristics of autonomic dysfunction, such as refractory hypertension, can seem selective for the use of clonidine and, because of its reliance on central alpha(2)-activity for its hypotensive effects, clonidine may induce hypertension in patients with autonomic dysfunction. Clonidine should be used with great caution when autonomic dysfunction is suspected.
Angel L Backo; Steven L Clause; Darren M Triller; Karen A Gibbs
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Annals of pharmacotherapy     Volume:  36     ISSN:  1060-0280     ISO Abbreviation:  Ann Pharmacother     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-08-28     Completed Date:  2003-02-05     Revised Date:  2013-08-21    
Medline Journal Info:
Nlm Unique ID:  9203131     Medline TA:  Ann Pharmacother     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1396-8     Citation Subset:  IM    
Albany College of Pharmacy, Albany, NY 12208-3492, USA.
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MeSH Terms
Adrenergic alpha-Agonists / adverse effects*,  therapeutic use
Blood Pressure / drug effects
Chronic Disease
Clonidine / adverse effects*,  therapeutic use
Fructose / analogs & derivatives*,  therapeutic use
Hypertension / chemically induced*
Neuroprotective Agents / therapeutic use
Pain / drug therapy,  etiology
Pain Measurement
Paraplegia / complications
Spinal Cord Injuries / complications*
Reg. No./Substance:
0/Adrenergic alpha-Agonists; 0/Neuroprotective Agents; 0H73WJJ391/topiramate; 30237-26-4/Fructose; 4205-90-7/Clonidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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