Home Drug Guide Quinethazone and Reserpine

Drug Guide

Generic Name

Quinethazone and Reserpine

Brand Names Hydromox R

Classification

Therapeutic: Antihypertensive, Diuretic (Quinethazone), Antipsychotic (Reserpine)

Pharmacological: Diuretic (Quinethazone), Adrenergic Neuron Blocker (Reserpine)

FDA Approved Indications

Hypertension (Reserpine)
Edema (Quinethazone)

Mechanism of Action

Quinethazone inhibits sodium and chloride reabsorption in the distal tubules of the kidney, promoting diuresis. Reserpine irreversibly blocks the storage of neurotransmitters (dopamine, norepinephrine, serotonin) in sympathetic nerve endings, reducing sympathetic activity and lowering blood pressure.

Dosage and Administration

Adult: Dose varies; typically, Reserpine 0.1-0.5 mg once daily, titrated as needed. Quinethazone dosage depends on indication and response.

Pediatric: Not generally recommended for children.

Geriatric: Use cautiously; start at lower doses due to increased sensitivity.

Renal Impairment: Adjust dose based on renal function.

Hepatic Impairment: Use with caution; no specific dosage adjustment information.

Pharmacokinetics

Absorption: Orally absorbed.

Distribution: Widely distributed throughout the body.

Metabolism: Primarily hepatic metabolism.

Excretion: Renal excretion; metabolites and unchanged drug.

Half Life: Reserpine: approximately 24 hours.

Contraindications

Depressive states, peptic ulcer, asthma, head trauma.
Known hypersensitivity to the components.

Precautions

Use with caution in patients with Parkinson's disease, depression, or peptic ulcer disease. Monitor blood pressure closely. Risk of depression with Reserpine.

Adverse Reactions - Common

Sedation, nasal congestion, gastrointestinal upset (Common)

Adverse Reactions - Serious

Depression, bradycardia, peptic ulcer exacerbation, nasal congestion leading to potential airway compromise (Serious (less common))

Drug-Drug Interactions

MAO inhibitors, centrally acting agents, tricyclic antidepressants, other antihypertensives

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

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

Diagnoses:

Risk for hypotension, risk for depression, impaired gas exchange due to nasal congestion.

Implementation: Administer as prescribed; monitor vitals regularly; evaluate mental health status.

Evaluation: Assess blood pressure response, mental health status, and adverse effects.

Patient/Family Teaching

Take medication exactly as prescribed.
Report signs of depression or suicidal ideation.
Caution about possible sedation and orthostatic hypotension.
Avoid abrupt discontinuation.

Special Considerations

Black Box Warnings:

Risk of depression and suicidal thoughts with Reserpine.

Genetic Factors: None specific.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Severe hypotension, depression, rapid decrease in blood pressure.

Treatment: Supportive care, IV fluids, activated charcoal if ingestion is recent, monitor cardiovascular status.

Storage and Handling

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

Stability: Stable under recommended storage conditions.