NR 565 Week 3 Discussion: ANS Case Study/ Responses
Responses
Kaycee Parrillo
Hello Kaycee. Thanks for your post. I agree with your treatment goals of discontinuing
clonidine since the patient presents with adverse side effects. As reported by the patient, the
tremors have since increased since she was placed on clonidine. However, you should have a
plan to gradually discontinue the medication by tapering before eventually introducing
propranolol. Considering the side effects on both drugs on patient with tremor, research shows
that propranolol has been effective in reducing tremors with limited side effects as opposed to
clonidine (Hall et al., 2016). I could not locate the article you used in this post, but found a
similar study investigating the effect of clonidine in patients with essential tremor in double-
blind placebo-controlled design, clonidine therapy was ineffective in treating essential tremor
(Koller et al., 1986). It could be argued that the introduction of clonidine did not yield any
effects on the patient. Therefore, a replacement would be the best option for Margaret.
References:
Hall, K., Kossowsky, J., Oberlander, T., Kaptchuk, T., Saul, J., & Wyller, V. et al. (2016).
Genetic Variation in Catechol-O-Methyltransferase Modifies Effects of Clonidine
Treatment in Chronic Fatigue Syndrome. The Pharmacogenomics Journal, 16(5), 454-
460. DOI: 10.1038/tpj.2016.53
Koller, W., Herbster, G., & Cone, S. (1986). Clonidine in the treatment of essential tremor.
Movement Disorders, 1(4), 235–237. https://doi.org/10.1002/mds.870010403
This study source was downloaded by 100000847795904 from CourseHero.com on 05-31-2022 16:16:58 GMT -05:00
https://www.coursehero.com/file/78742054/NR565-Week-3-ANS-Case-Study-Discussion-Responsesdocx/
Responses
Kaycee Parrillo
Hello Kaycee. Thanks for your post. I agree with your treatment goals of discontinuing
clonidine since the patient presents with adverse side effects. As reported by the patient, the
tremors have since increased since she was placed on clonidine. However, you should have a
plan to gradually discontinue the medication by tapering before eventually introducing
propranolol. Considering the side effects on both drugs on patient with tremor, research shows
that propranolol has been effective in reducing tremors with limited side effects as opposed to
clonidine (Hall et al., 2016). I could not locate the article you used in this post, but found a
similar study investigating the effect of clonidine in patients with essential tremor in double-
blind placebo-controlled design, clonidine therapy was ineffective in treating essential tremor
(Koller et al., 1986). It could be argued that the introduction of clonidine did not yield any
effects on the patient. Therefore, a replacement would be the best option for Margaret.
References:
Hall, K., Kossowsky, J., Oberlander, T., Kaptchuk, T., Saul, J., & Wyller, V. et al. (2016).
Genetic Variation in Catechol-O-Methyltransferase Modifies Effects of Clonidine
Treatment in Chronic Fatigue Syndrome. The Pharmacogenomics Journal, 16(5), 454-
460. DOI: 10.1038/tpj.2016.53
Koller, W., Herbster, G., & Cone, S. (1986). Clonidine in the treatment of essential tremor.
Movement Disorders, 1(4), 235–237. https://doi.org/10.1002/mds.870010403
This study source was downloaded by 100000847795904 from CourseHero.com on 05-31-2022 16:16:58 GMT -05:00
https://www.coursehero.com/file/78742054/NR565-Week-3-ANS-Case-Study-Discussion-Responsesdocx/
