Nurses Compass
Drug Guide
Bethanidine Sulfate
Classification
Therapeutic: Antihypertensive agent
Pharmacological: Adrenergic neuron blocker
FDA Approved Indications
- Hypertension
Mechanism of Action
Bethanidine inhibits adrenergic neuron function, decreasing sympathetic outflow and thus lowering blood pressure.
Dosage and Administration
Adult: Initially, 300 mg daily in divided doses; titrate based on response and tolerability.
Pediatric: Not typically used in pediatric patients.
Geriatric: Adjust dose carefully due to increased sensitivity and risk of adverse effects.
Renal Impairment: Use with caution; dosage adjustment may be necessary.
Hepatic Impairment: Use with caution; hepatic metabolism may alter drug levels.
Pharmacokinetics
Absorption: Well absorbed orally.
Distribution: Widely distributed; crosses blood-brain barrier.
Metabolism: Partially metabolized in the liver.
Excretion: Excreted primarily in urine.
Half Life: Approximately 6-8 hours.
Contraindications
- Known hypersensitivity to bethanidine or related compounds.
Precautions
- Use cautiously in patients with renal or hepatic impairment, cardiovascular disease, or those on other antihypertensives; monitor blood pressure regularly.
Adverse Reactions - Common
- Dizziness (Common)
- Dry mouth (Common)
- Sedation (Common)
Adverse Reactions - Serious
- Bone marrow suppression leading to leukopenia or thrombocytopenia (Rare)
- Serious hypotension or hypertensive crises (Rare)
Drug-Drug Interactions
- Other antihypertensives, especially vasodilators and centrally acting agents
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor blood pressure and heart rate regularly. Watch for signs of hypotension and CNS effects.
Diagnoses:
- Risk for falls related to hypotension and dizziness.
Implementation: Administer doses as prescribed, usually divided throughout the day. Educate patient on potential side effects.
Evaluation: Assess effectiveness by monitoring blood pressure; evaluate for adverse effects and tolerance.
Patient/Family Teaching
- Instruct patient to rise slowly from sitting or lying positions to prevent dizziness.
- Advise patient to report signs of adverse reactions such as sore throat, fever, unexplained bleeding.
- Explain importance of regular blood pressure monitoring.
Special Considerations
Black Box Warnings:
- None reported currently.
Genetic Factors: No specific genetic considerations documented.
Lab Test Interference: May alter blood glucose and other lab results.
Overdose Management
Signs/Symptoms: Severe hypotension, somnolence, CNS depression.
Treatment: Supportive care; administer activated charcoal if ingestion was recent; monitor vital signs; provide symptomatic treatment as needed.
Storage and Handling
Storage: Store at room temperature, away from moisture and light.
Stability: Stable under recommended storage conditions.