Name of Patient

Baby Vellita

Age

20 y.o

Height

52

Diagnosis

G1P1 PU 31 wks. AOG/LMP cephalic, IPTL, severe

preeclampsia with pulmonary congestion

Sex

Female

Weight

60 kg

Date of Admission

April 28, 2015

Body
Build

endomorph

Doctor
Dr. Karen Kris Balbosa, MD

DRUG DATA
Generic name:
Methyldopa

CLASSIFICATION
Pharmacologic:
Sympatholytic
(centrally acting)

Trade name/s:
Methyldopa
Patients dose:
250mg 1tab TID

Therapeutic:
Antihypertensive

MECHANISM OF
ACTION

Mechanism of action
not conclusively
demonsrated;
probably due to drugs
metabolism, which
lowers arterial BP by
stimulating the alpha2adrenergic receptors,
which in turn
decreases
sympathetic outflow
from the CNS

Maximum dose:
500mg/day in
divided doses

INDICATIONS

General:
> hypertension
> IV
methyldopate:
acute
hypertensive
crisis; not drug of
choice because
slow onset of
action
> unlabeled use:
hypertension of
pregnancy

Pregnancy Category
Risk: B
Minimum dose:
250mg

Onset: varies
Peak: 2-4 hr

Availability:
Tablets 250,
500mg; Injection
50mg/ml

Duration: 12-24 hr
Metabolism: hepatic;
1-8 hr

Patients actual
indication:
Methyldopa is
given to patient to
treat pregnancyincduced
hypertension

Distribution: crosses
placenta, enters
breast milk
Route:
PO

Source: 2011
Lippincotts NDG

Excretion: urine

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

CONTRAINDICATI
ON

Contraindicated with
hypersensitivity to
methyldopa, active
hepatic disease,
previous methyldopa
therapy associated with
liver disorders.

Precaution:
Use cautiously with
previous liver disease,
renal failure, dialysis,
bilateral cerebrovascular
disease; pregnancy,
lactation

ADVERSE
EFFECTS

CNS: sedation,
headache,
asthenia,
weakness
CV: bardycardia,
myocarditis
Dermatologic: rash
seen as eczema or
lichenoid eruption,
toxic epidermal
necrolysis fever
Endocrine: breast
enlargement,
gynceomastia,
lactation

Interactions:
> drug-drug: potentiation
of the pressor effects of
sympathomimetic
amines; increased
hypotension with
levodopa, risk of
hypotension during
surgery with central
anesthetics
> drug-lab test:
methyldopa may
interfere with tests for
urinary uric acid, serum
creatinine, AST, urinary
catecholamines

GI: nausea,
vomiting,
distention,
constipation,
hepatic necrosis

Source: 2011
Lippincotts NDG

Source: 2011
Lippincotts NDG

Hematologic:
positive Coombs
test, hemolytic
anemia, bone
marrow
depression
Other: nasal
stuffiness, mild
arthralgia, myalgia,
septic shock-like
symptoms

NURSING
RESPONSIBILITIE
S

Before:
> check doctors order
> assess sensitivity to methyldopa,
hepatic disease, renal failure, dialysis
> assess weight, skin color, lesions,
mucous membrane color, lesions,
orientation, affect
> educate client about the drug, its
purpose and importance
During:
> check the label twice
> administer at the right dose and in
the right time
> do not crush nor chew tablets,
swallow whole
> discontinue drug if fever,
abnormalities in liver function tests, or
jaundice occurs
> discontinue drug if Coombspositive hemolytic anemia occurs
After:
> monitor blood counts periodically to
detect haemolytic anemia
> monitor hepatic function, especially
in the first 6-8 wk of therapy or if
unexplained fever appears
> ensure that methyldopa is not
reinstated in such patients
> report unexplained, prolonged
general tiredness; yellowing of the
skin or eyes; fever; bruising; rash.
> document and record.

Source: 2011 Lippincotts Nursing

Drug Guide