Hypotension may occur, and these drugs must be used cautiously in patients predisposed to this effect. The major side effects are dry mouth and sedation. Clonidine is actually FDA-approved when epidurally administered for the treatment of cancer-associated neuropathic pain. Because of limited experience, clonidine is not generally considered a first-line drug, but it may be used in refractory cases. Clonidine has been shown to be analgesic in chronic headache, chronic neuropathic and nonneuropathic noncancer pain syndromes, and cancer-related neuropathic pain. Although one study suggests that only a small proportion of patients with chronic pain respond to clonidine, responders may attain excellent analgesia. Argoff MD, in Pain Management Secrets (Third Edition), 2009 16 What role do tizanidine and clonidine have as adjuvant analgesics?Īlpha-2 adrenergic agonists can be multipurpose, nonspecific analgesics tizanidine and clonidine are used for this purpose in the United States. Alpha-2 adrenergic agents are also used as analgesics in veterinary medicine Lemke (2004), Daunt and Steffey (2002).īrian Thiessen MD. Phenylpropanolamine (dl-norephedrine), which has previously being widely used as a nasal decongestant acts mainly through alpha-2 receptors Flavahan (2005). Alpha-2 antagonists are being studied as agents to reverse alpha-2 agonist-induced anesthesia, for the treatment of diabetes and to increase salivation. Alpha-2 agonists may also have a gastroprotective effect Gyires et al (2000).Īgents with significant activity as alpha-2 antagonists are used clinically to treat depression Millan (2004) and may be useful in the treatment of neurodegenerative diseases Marien et al (2004). It appears that most, if not all, of these effects are mediated by the alpha-2A subtype. More recently, alpha-2 receptor agonists have been found beneficial in the suppression of opiate, alcohol, and nicotine withdrawal symptoms, in the treatment of attention-deficit hyperactivity disorder and neuropathic pain, as adjuncts to general anesthesia, and topically for the treatment of glaucoma Hunt et al (1985), Kleber et al (1985), Eisenach et al (1996), Chacko and Camras (1994). Bylund, in xPharm: The Comprehensive Pharmacology Reference, 2007 DisordersĪlpha-2 adrenoceptor agonists have been used clinically in the treatment of hypertension for many years Michel et al (1992). Interestingly, the pharmacological actions of specific alpha2 agonists and antagonists are likely the result of modulating these central receptors rather than those in the peripheral nervous system.David B. The central actions of alpha2 receptors are still being elucidated.
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