Methyldopa is a
prodrug which is
metabolized to the active agent,
Alpha-methylnorepinephrine acts in the brain,
inhibiting adrenergic outflow from the brainstem.
Inhibition of sympathetic outflow results
in a decrease in blood pressure.
Methyldopa 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
stoke volume occurs due to increased venous
pooling (decreased preload).
renal blood flow and function is
maintained during methyldopa treatment,
methyldopa maybe valuable in managing
hypertensive patients with renal insufficiency.
Bradycardia (in patients with SA nodal
Hepatoxicity (avoid in patients with
positive Coombs' test (20%)\
1-5% of those with postive Coombs'
develop hemolytic anemia (requiring immediate
discontinuation of the drug)