用途,副作用,注意事項

1. Clonidine
周孫鴻藥師

3. 作用~降血壓
• 透過刺激中樞交感神經的甲型受器(alpha2-
adrenergic receptors),降低交感神經活性,進而減少
血管阻力跟減慢心跳速度,達到降血壓效果

4. 副作用
• 因為clonidine抑制交感神經,所以減少了腎上腺
素、正腎上腺等分泌,造成以下副作用:
• 1.嗜睡
• 2.心跳慢
• 3.低血壓

5. Beers Criteria:
• 因為clonidine有中樞抑制效果,跟心跳慢及姿勢
性低血壓的風險,所以不建議作為65歲以上長者
第一線的降血壓藥
• (Ref.) Clonidine is identified in the Beers Criteria as a potentially
inappropriate medication in patients 65 years and older (independent
of diagnosis or condition) for hypertension treatment due to high risk
of CNS adverse effects and risk of bradycardia and orthostatic
hypotension associated with central alpha blockers. Avoid clonidine as
a first-line antihypertensive (Beers Criteria [AGS 2019]).

6. 周藥師補充
• Clonidine在高血壓的治療中,本不會放在第一線
使用,而是當作難治型血壓(resistance hypertension)
的選項
• Clonidine雖然嗜睡,但適合用在躁症明顯(例如失
智行為異常)的長輩; 雖然會緩脈,但適合用在心
跳過快的長輩