Figure 719

Central and peripheral adrenergic neuronal blocking agents. Reserpine is the most popular rauwolfia product used. It is absorbed poorly (approximately 30%); peak plasma concentrations occur in 1 to 2 hours. Catecholamine depletion begins within 1 hour of drug administration and is maximal in 24 hours. Catecholamines are restored slowly. Chronic doses of reserpine are cumulative. Blood pressure is maximally lowered 2 to 3 weeks after beginning therapy. Reserpine is metabolized by the liver; 60% of an oral dose is recovered in the feces. Less than 1% is excreted in the urine as unchanged drug. The plasma half-life (12 to 16 days) is not prolonged in patients with renal insufficiency.

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