These can include trying a different stimulant or using a nonstimulant such as atomoxetine or an alpha-adrenergic agonist
. Because these medications have very different side effect profiles, they may be more acceptable to the teenager, although they also may have different efficacy.
Reduction in halothane requirement by clonidine, an alpha-adrenergic agonist
. Anesth Analg 1982;67:741-5.
The greatest concern with the use of an alpha-adrenergic agonist
such as xylazine is the severe cardiopulmonary depressant effects.
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.[1-6,8,10-12] Clonidine has also been used to treat migraines, menopausal complaints, narcotic withdrawal symptoms, spasticity after spinal cord injury, and attention-deficit hyperactivity disorder. Bradycardia is a side effect only rarely described when clonidine is used at prescribed dosages.
Only recently have we had Food and Drug Administration-approved treatments for the persistent facial erythema of rosacea, the alpha-adrenergic agonists
brimonidine and oxymetazoline.
Brachial plexus block with bupivacaine: Effects of added alpha-adrenergic agonists
: Comparison between clonidine and epinephrine.
Sympathomimetics (alpha-adrenergic agonists
) include apraclonidine (Iopidine), which has no human eye data, and brimonidine (Alphagan P), which has one case report in pregnancy and breastfeeding showing no fetal or nursing infant harm.
Effects of central alpha-adrenergic agonists
on hormoneinduced 3% NaCl and water intake.
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.
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).