- Methyldopa (Aldomet) is a prodrug which
is metabolized to the active agent, alpha-methylnorepinephrine.
- Alpha-methylnorepinephrine
acts in the brain, inhibiting adrenergic
outflow from the brainstem. Inhibition of
sympathetic outflow results in a decrease
in blood pressure.
- Methyldopa (Aldomet) produces no
change in cardiac output in younger patients, but
in older patients a decline in cardiac output
results from reduced heart rate and stroke
volume.
- The reduction in stroke
volume occurs due to increased venous
pooling (decreased preload).
- Since renal blood flow and
function is maintained during methyldopa
treatment, methyldopa maybe valuable in managing
hypertensive patients with renal insufficiency.
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