These can include trying a different stimulant or using a nonstimulant such as atomoxetine or an alpha-adrenergic agonist
Reduction in halothane requirement by clonidine, an alpha-adrenergic agonist
The greatest concern with the use of an alpha-adrenergic agonist such as xylazine is the severe cardiopulmonary depressant effects.
However, because its use can result in poor muscle relaxation, muscle tremors, myotonic contractions, opisthotonus, and rough recovery, ketamine is rarely used alone (7-10); it is often paired with drugs such as alpha-adrenergic agonists, benzodiazepines, and propofol for chemical restraint and induction of anesthesia in birds.
Its action is similar to that of phenylephrine, an alpha-adrenergic agonist
, (2) and it has been used for treating hypotension in doses of about 100 mg 3 times a day.
Clonidine is a alpha-adrenergic agonist
with sympatholytic activity[1-9] used in the treatment of hypertension.
Clonidine, a centrally acting alpha-adrenergic agonist
, is a safe and effective treatment for hypertension that has been available for decades.
Several general interventions assist in prevention of UI: preventing urinary tract infections and fecal impaction, controlling diabetes mellitus and heart failure, correcting hypercalemia, reducing diuretic fluids, avoiding physical or chemical restraints and managing medications that can cause UI (ACE inhibitors, calcium channel blockers, beta- and alpha-adrenergic agonists
, alpha-adrenergic blockers, diuretics, cholinesterase inhibitors, psychotropics, narcotic analgesics and anticholinergics).
Topical alpha-adrenergic agonists
(Alphagan) decrease fluid production as well as increase fluid outflow.
Alpha-adrenergic agonists should rarely be used in older women because of the effect on hypertension, cardiac arrhythmias, and angina.
Medications That Can Potentially Affect Continence (12) Type of Medication Potential Effects on Continence Diuretics Polyuria, frequency, urgency Antichotinergics Urinary retention, overflow Psychotropics Antidepressants Anticholinergic actions, sedation Antipsychotics Anticholinergic actions, sedation, rigidity, immobilit Sedatives/Hypnotics Sedation, delirium, immobility muscle relaxation Narcotic analgesics Urinary retention, fecal impaction, sedation, delirium Alpha-adrenergic blockers Urethral relaxation Alpha-adrenergic agonists Urinary retention Beta-adrenergic agonists Urinary retention Calcium channel blockers Urinary retention Alcohol Polyuria, frequency, urgency, sedation, delirium,immobility
Pharmaceuticals (see Table 1) including sedatives/hypnotics, narcotics, diuretics, anticholinergics, alpha-adrenergic agonists
or alpha-adrenergic blockers, and calcium channel blockers can contribute to the development and exacerbation of incontinence (Ghoniem & Hassouna, 1997).