A patient complains to the nurse that the clonidine (Catapres) ...

[PhilipSeeMore]

A patient complains to the nurse that the clonidine (Catapres) recently prescribed for hypertension is causing drowsiness. Which response by the nurse to this concern is appropriate?
 
  a. Drowsiness is a common side effect initially, but it will lessen with time.
  b. You may also experience orthostatic hypotension along with the drowsiness.
  c. You may be at risk for addiction if you have central nervous system side effects.
  d. You should discontinue the medication and contact your prescriber.

Question 2

A nurse is teaching a patient about a new prescription for reserpine (Serpasil) for hypertension. Which statement by the patient indicates the need for further teaching?
 
  a. Depressive side effects are common and will improve over time.
  b. I should report gastrointestinal side effects to the provider.
  c. I should stand up slowly when getting up and lie down if I feel dizzy.
  d. Therapeutic effects may not be optimal for a couple of weeks.

[bookworm410]

Answer to Question 1

ANS: A
CNS depression, evidenced in this patient by drowsiness, is common in about 35 of the population. These responses become less intense with continued drug use. Orthostatic hypotension is less likely with clonidine, because its antihypertensive effects are not posture dependent. The experience of drowsiness does not indicate abuse potential. The patient should not discontinue the medication abruptly because of the potential for rebound hypertension; the patient should contact the prescriber before stopping the medication.

Answer to Question 2

ANS: A
Reserpine can produce severe depression, which may persist for months during drug therapy and after the drug is withdrawn. Reserpine can stimulate the secretion of gastric acid, which can cause ulcers; it also can increase the tone and motility of intestinal smooth muscle, which can cause cramps and diarrhea. Reserpine can cause orthostatic hypotension, so patients should be counseled to rise slowly when standing up and to sit or lie down if they feel dizzy. Reserpine works by depleting norepinephrine, and the processes necessary for this may take 1 to 2 weeks.