Essential and/or malignant hypertension

 Adverse reactions-

Cardiovascular -      orthostatic dizziness and syncope . postural hypotension

CNS -     convulsions , choreform movements, mental abberations, tremor, and paresthesis

GI-   ileus, constipation ( some times preceded by small .frequent liquid stools)
 vomiting, nausea, anorexia, glossitis, and dryness of mouth
 
GU- urinary retention, impotence, decreased libido,

Respiratory- intestinal pulmonary edema, and fibrosis

Special senses-   blurred vision, dilated puplis

Miscellaneous - weakness, fatigue, sedation

Special precautions-
Mecamylamine should not be used in mild , moderate, labile hypertension and may unsuitable
in uncooperative patients.

It is contraindicated in coronary insufficiency  or recent myocardial infarction

Renal insufficiency- mecamylamine should be given with great discretion if at all when renal
insufficiency is manifested by a rising or elevated BUN .
The drug is contraindicated in uremia

Other contraindications are glaucoma, organic pyloric stenosis or hypersensitivity to the product

CNS effects- readily penetrates into the brain and produce CNS effects.
Tremor, cholreiform movements may occur rarely

Dicontinuation of therapy-  the effects of mecamylamine may  last hours to days after therapy
is discontinued

Renal function impairment- evaluate patients condition particularly renal and cardovascular
function. Give with great discretion
 
Special risk- frequent bowel movements with abdominal distention and decreased borborygmi
may be first sign of paralytic ileus. If these are present discontinue the drug

Pregnancy- administer to a pregnant women only if clearly needed.

Lactation-  decide whether to discontinue  breast feeding or the drug depending on the
importance of drug to the mother.

Children- safety and and efficacy have not been established

 Indication-
Essential and/or malignant hypertension

Dosage-
Usually started with 2.5mg twice daily
Determine the initial dosage by blood pressure in the erect position at the time of maximal drug
effect as well as by other signs and symptoms of orthostatic position.

Pregnancy-
Administer to a pregnant women only if clearly needed.

Lactation- 
Decide whether to discontinue  breast feeding or the drug depending on the
importance of drug to the mother.

Children-
Safety and and efficacy have not been established