title: [Tolerance of the oral clonidine test in 180 patients: efficacy of the volemic expantion in controlling arterial hypotension].
abstract: Clonidine stimulation test is widely used to evaluate growth hormone secretion. Side effects are somnolence (35%) and arterial hypotension (AH) (5%). The aims of this paper were to evaluate the tolerance to this test regarding blood pressure (BP) decrease, sedation and the efficacy of saline resuscitation to prevent AH. BP was measured at basal, 60 and 120 min. Sedation was determined by the Ramsay scale. Patients were divided into two groups: Group 1 (n = 80) received saline resuscitation only upon severe AH (drop of mean BP [MBP] > 20% from initial MBP) and/or postural hypotension; Group 2 (n = 100) received saline resuscitation from the beginning of the test. Both groups presented a significant MBP fall and 75% presented somnolence at 60 min. MBP drop did not correlate with either sedation or the clonidine dose. Group 1 presented more hypotension (59% x 28%) and greater MBP drop at 60 min. Only one patient had an asthma attack. We conclude that the hypotension effects caused by oral clonidine diminish with saline resuscitation since the beginning of the test. This test must have specialized medical support with strict BP evaluation and precocious intervention when needed.
authors.affiliation: Centro de Provas Funcionais, Fleury, Divisão de Endocrinologia e Metabologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP. suemi.marui@fleury.com.br
authors.forename: Suemi
authors.initials: S
authors.lastname: Marui
authors.forename: Cláudia H M C
authors.initials: CH
authors.lastname: Oliveira
authors.forename: Sílvia C A L
authors.initials: SC
authors.lastname: Souza
authors.forename: Karina
authors.initials: K
authors.lastname: Berger
authors.forename: Cristina
authors.initials: C
authors.lastname: Khawali
authors.forename: Omar M
authors.initials: OM
authors.lastname: Hauache
authors.forename: Rui M B
authors.initials: RM
authors.lastname: Maciel
authors.forename: José Gilberto H
authors.initials: JG
authors.lastname: Vieira
mesh_terms: D000293:Adolescent; D000316:Adrenergic alpha-Agonists / Q000009:adverse effects*; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003000:Clonidine / Q000009:adverse effects*; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced*; D005260:Female; D013006:Growth Hormone / Q000187:drug effects / Q000378:metabolism*; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000517:prevention & control; D008297:Male; D010901:Pituitary Function Tests / Q000009:adverse effects / Q000379:methods; D010953:Plasma Volume / Q000187:drug effects*; D012462:Saline Solution, Hypertonic / Q000627:therapeutic use; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D000316:Adrenergic alpha-Agonists; D012462:Saline Solution, Hypertonic; D013006:Growth Hormone; D003000:Clonidine