Reserpine

Reserpine is an alkaloid obtained from the roots of Rauwolfia serpentina, was among the first drugs used for the management of hypertension and psychosis. It was the first drug found to interfere with the human sympathetic nervous system, it blocks the ability of aminergic transmitter vesicles to take up and store biogenic amines resulting in depletion of norepinephrine, dopamine and serotonin in both central and peripheral neurons. It was approved by the FDA in 1953. Recently, the use of it as an antihypertensive agent has diminished due to its adverse CNS effects and the development of newer antihypertensive drugs that are equally effective and much better tolerated. Use of rauwolfia alkaloids in patients with psychotic disorders has been replaced by treatment with other, more effective agents.

Brands
RESERPINE
Adult Dose
Dose: 0.1 to 1 mg
Single Dose: 0.55 (0.55)
Frequency: 24 hourly
Route: PO
Instructions:
Neonatal
Paedriatic
Characteristics
. It is of Synthetic origin. . The Molecular Weight of Reserpine is 608.70. Its pKa is 6.6.
Contraindications
Reserpine is contraindicated in conditions like Depression,Renal failure.
Effects
The severe or irreversible adverse effects of Reserpine, which give rise to further complications include Congestive heart failure, Bronchospasm, Dyskinesias, Parkinsonism, Depression, Dystonia, Aggravation of peptic ulcer.The signs and symptoms that are produced after the acute overdosage of Reserpine include Bronchospasm, Coma, Hypothermia, Palpitations, Respiratory depression, Tremor, Low cardiac output, Dystonia, Impaired conciousness, Progressive decrease in BP, Vasodilatation.The symptomatic adverse reactions produced by Reserpine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Drowsiness, Dyspepsia, Weight gain, Nightmares, Galactorrhea, Menstrual irregularity, Amenorrhea, Disturbed sleep, Nasal obstruction, Looseness of bowel.
Indications
Reserpine is primarily indicated in conditions like Agitated psychosis, Cerebrovascular accident, Hypertension in pregnancy, Mild to moderate hypertension, and can also be given in adjunctive therapy as an alternative drug of choice in Peripheral vasospasm.
Interactions
Reserpine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementDisopyramideEphedrineFenfluramine (HCl)Glyceryl TrinitrateHalothaneLevodopaMolindoneConcurrent use with Molindone increases certain serious side effects.Obidoxime (Cl)OxprenololConcomitant use may produce any excessive reduction of sympathetic activity. QuinidineThalidomide These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Zimmerman method for assaying 17-kotasteroids Rogers Spot Test for urinary VMA or other GuaicolsPorter-Silber Reaction for Urinary 17-OH-Corticosteroids
Risks
Drug should not be given to Pregnant Mothers, patients suffering from Kidney dysfunction, and Geriatrics.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Tab Store at room temperature. Protect from Sunlight.
Warnings
It should be used with caution in the presence of gallstones, cardiac arrhythmias, renal insufficiency, myocardial infarction, epilepsy, or allergic conditions such as bronchial asthma and in debilitated or elderly patients. Decrease in the dosage or withdrawal of reserpine causes the reversal of many side effects although mental disorders may persist for months and hypotensive effects may persist for weeks after the termination of treatment.
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