Guanethidine: Difference between revisions

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'''Guanethidine''' is a [[pharmacology|pharmacological]] agent that is primarily used in the management of [[hypertension]]. It belongs to the class of drugs known as [[sympatholytic]]s, which work by inhibiting the release of [[norepinephrine]] from nerve endings, thereby reducing the activity of the [[sympathetic nervous system]].
==Guanethidine==


== Mechanism of Action ==
[[File:Guanethidine.svg|Guanethidine chemical structure|thumb|right]]


Guanethidine works by replacing norepinephrine in the storage vesicles of [[sympathetic nerve endings]]. This results in a depletion of norepinephrine stores and a reduction in the transmission of sympathetic impulses. The overall effect is a decrease in [[blood pressure]].
'''Guanethidine''' is a medication that was historically used as an [[antihypertensive]] agent. It is a [[sympatholytic]] drug that works by inhibiting the release of [[norepinephrine]] from sympathetic nerve endings, thereby reducing blood pressure. Guanethidine was once a common treatment for [[hypertension]], but its use has declined with the development of newer antihypertensive drugs.


== Pharmacokinetics ==
==Mechanism of Action==


After oral administration, guanethidine is slowly absorbed from the [[gastrointestinal tract]]. It is not metabolized and is excreted unchanged in the urine. The onset of action is slow, and the duration of action is long, making it suitable for once-daily dosing.
Guanethidine acts by entering the adrenergic neurons through the [[norepinephrine transporter]] (NET). Once inside the neuron, it is stored in [[synaptic vesicles]], displacing norepinephrine. This displacement prevents the release of norepinephrine into the synaptic cleft, leading to decreased stimulation of [[adrenergic receptors]] on the [[vascular smooth muscle]], resulting in vasodilation and reduced blood pressure.


== Clinical Uses ==
==Pharmacokinetics==


Guanethidine is used in the treatment of moderate to severe hypertension. It may be used alone or in combination with other antihypertensive agents. It is also used in the management of [[pheochromocytoma]], a rare tumor of the adrenal glands that causes excessive release of catecholamines.
Guanethidine is poorly absorbed from the gastrointestinal tract, and its bioavailability is variable. It is metabolized in the liver and excreted primarily in the urine. The onset of action is slow, and the full antihypertensive effect may take several days to develop. The drug has a long half-life, which allows for once-daily dosing.


== Side Effects ==
==Clinical Use==


Common side effects of guanethidine include [[orthostatic hypotension]], [[diarrhea]], [[nasal congestion]], and [[sexual dysfunction]]. Rare but serious side effects include [[cardiac arrhythmias]] and severe [[hypotension]].
[[File:Guanethidine_3D_ball.png|Guanethidine 3D ball model|thumb|left]]


== Contraindications ==
Guanethidine was primarily used to treat moderate to severe hypertension. It was often reserved for patients who did not respond to other antihypertensive medications. Due to its side effect profile and the availability of more effective and better-tolerated drugs, guanethidine is now rarely used.


Guanethidine is contraindicated in patients with [[pheochromocytoma]], [[heart failure]], and severe [[coronary artery disease]]. It should be used with caution in patients with [[renal impairment]] due to the risk of accumulation and toxicity.
==Side Effects==


== Drug Interactions ==
Common side effects of guanethidine include [[orthostatic hypotension]], [[diarrhea]], and [[sexual dysfunction]]. Orthostatic hypotension is particularly problematic, as it can lead to dizziness and fainting upon standing. Other side effects may include [[nasal congestion]], [[fatigue]], and [[edema]].


Guanethidine can interact with a number of other medications, including [[tricyclic antidepressants]], [[monoamine oxidase inhibitors]], and [[sympathomimetic]] drugs. These interactions can lead to an increase in blood pressure and should be avoided.
==History==
 
Guanethidine was first introduced in the 1950s and was widely used in the treatment of hypertension during the 1960s and 1970s. However, with the advent of newer classes of antihypertensive agents, such as [[ACE inhibitors]], [[beta blockers]], and [[calcium channel blockers]], the use of guanethidine has significantly declined.
 
==Related Pages==
 
* [[Hypertension]]
* [[Sympatholytic]]
* [[Adrenergic receptor]]
* [[Norepinephrine]]


[[Category:Pharmacology]]
[[Category:Antihypertensive agents]]
[[Category:Antihypertensive agents]]
[[Category:Sympatholytics]]
[[Category:Sympatholytics]]
{{medicine-stub}}
{{No image}}
<gallery>
File:Guanethidine.svg|Guanethidine chemical structure
File:Guanethidine 3D ball.png|Guanethidine 3D ball model
</gallery>

Latest revision as of 11:16, 23 March 2025

Guanethidine[edit]

Guanethidine chemical structure

Guanethidine is a medication that was historically used as an antihypertensive agent. It is a sympatholytic drug that works by inhibiting the release of norepinephrine from sympathetic nerve endings, thereby reducing blood pressure. Guanethidine was once a common treatment for hypertension, but its use has declined with the development of newer antihypertensive drugs.

Mechanism of Action[edit]

Guanethidine acts by entering the adrenergic neurons through the norepinephrine transporter (NET). Once inside the neuron, it is stored in synaptic vesicles, displacing norepinephrine. This displacement prevents the release of norepinephrine into the synaptic cleft, leading to decreased stimulation of adrenergic receptors on the vascular smooth muscle, resulting in vasodilation and reduced blood pressure.

Pharmacokinetics[edit]

Guanethidine is poorly absorbed from the gastrointestinal tract, and its bioavailability is variable. It is metabolized in the liver and excreted primarily in the urine. The onset of action is slow, and the full antihypertensive effect may take several days to develop. The drug has a long half-life, which allows for once-daily dosing.

Clinical Use[edit]

Guanethidine 3D ball model

Guanethidine was primarily used to treat moderate to severe hypertension. It was often reserved for patients who did not respond to other antihypertensive medications. Due to its side effect profile and the availability of more effective and better-tolerated drugs, guanethidine is now rarely used.

Side Effects[edit]

Common side effects of guanethidine include orthostatic hypotension, diarrhea, and sexual dysfunction. Orthostatic hypotension is particularly problematic, as it can lead to dizziness and fainting upon standing. Other side effects may include nasal congestion, fatigue, and edema.

History[edit]

Guanethidine was first introduced in the 1950s and was widely used in the treatment of hypertension during the 1960s and 1970s. However, with the advent of newer classes of antihypertensive agents, such as ACE inhibitors, beta blockers, and calcium channel blockers, the use of guanethidine has significantly declined.

Related Pages[edit]