Home Drug Guide Reserpine

Drug Guide

Generic Name

Reserpine

Brand Names Serpasil, Rau-sed, Sandril, Serpanray, Serpate, Hiserpia, Serpivite, Serpalan

Classification

Therapeutic: Antihypertensive / Antipsychotic

Pharmacological: Indolamine depleting agent, Adrenergic neuron blocker

FDA Approved Indications

  • Hypertension
  • Schizophrenia (less common now due to side effects)

Mechanism of Action

Reserpine depletes synaptic vesicles of catecholamines (dopamine, norepinephrine) and serotonin by inhibiting vesicular Monoamine Transporter 2 (VMAT2), leading to decreased sympathetic tone and sedative effects.

Dosage and Administration

Adult: Typically 0.25 to 0.5 mg twice daily, titrated according to response.

Pediatric: Not generally recommended for children.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Use with caution; dose adjustments may be necessary.

Hepatic Impairment: Use with caution; no specific dosage adjustments established.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed in body tissues.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily via the urine.

Half Life: Approximately 24 hours.

Contraindications

  • Depression (may worsen symptoms)
  • Peptic ulcer
  • Asthma

Precautions

  • History of depression or suicidal ideation
  • History of severe allergies
  • Use cautiously in patients with Parkinson’s disease, urinary obstruction, or cardiovascular disease.

Adverse Reactions - Common

  • Sedation or drowsiness (Common)
  • Nasal congestion (Common)
  • GI disturbances (nausea, diarrhea) (Common)

Adverse Reactions - Serious

  • Depression (Less common but significant)
  • Extrapyramidal symptoms (Rare)
  • Orthostatic hypotension (Common)

Drug-Drug Interactions

  • Monoamine oxidase inhibitors (risk of hypertensive crisis)
  • Other antihypertensives (potentiation)
  • Tricyclic antidepressants (may reduce effectiveness)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, mental status, and signs of depression.

Diagnoses:

  • Risk for decreased cardiac output
  • Risk for mood disturbances

Implementation: Administer as prescribed, usually before meals or at bedtime; monitor for side effects.

Evaluation: Effectiveness in lowering blood pressure, mood stability, and adverse reactions.

Patient/Family Teaching

  • Take exactly as prescribed.
  • Report symptoms of depression or mood changes.
  • Avoid abrupt discontinuation—taper under medical supervision.
  • Monitor blood pressure regularly.
  • Be cautious about driving or operating machinery until effects are known.

Special Considerations

Black Box Warnings:

  • Potential to cause severe depression and suicidal ideation.

Genetic Factors: Genetic variation in drug metabolism may influence response.

Lab Test Interference: May alter blood counts or liver function tests.

Overdose Management

Signs/Symptoms: Severe hypotension, bradycardia, depression, coma.

Treatment: Supportive care, IV fluids, vasopressors if needed, gastric lavage in early ingestion, activated charcoal.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.