Details of Drug Interaction | MecDDI

Drug General Information (ID: DDIL27KNXU)
Drug Name			Nitroprusside		Drug Info		Guanabenz		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Antihypertensive Agents				Sympatholytics
Structure

Mechanism of Nitroprusside-Guanabenz Interaction (Severity Level: Moderate)
Additive hypotensive effects Click to Show/Hide Mechanism Graph

Drug Name		Nitroprusside				Guanabenz
Mechanism		Antihypertensive agent Guanylate cyclase Agonist				Antihypertensive agent Alpha-2 adrenergic receptor Agonist
Key Mechanism Factor 1
		Factor Name		Guanylate cyclase soluble				Structure Sequence
		Protein Family		Adenylyl cyclase class-4/guanylyl cyclase family
		Protein Function		There are two types of guanylate cyclases: soluble forms and membrane-associated receptor forms. Activated by nitric oxide in the presence of magnesium or manganese ions. Click to Show/Hide
Key Mechanism Factor 2
		Factor Name		Adrenergic receptor alpha-2				Structure Sequence
		Protein Family		G-protein coupled receptor 1 family
		Protein Function		Alpha-2 adrenergic receptors mediate the catecholamine-induced inhibition of adenylate cyclase through the action of G proteins. The rank order of potency for agonists of this receptor is oxymetazoline > clonidine > epinephrine > norepinephrine > phenylephrine > dopamine > p-synephrine > p-tyramine > serotonin = p-octopamine. For antagonists, the rank order is yohimbine > phentolamine = mianserine > chlorpromazine = spiperone = prazosin > propanolol > alprenolol = pindolol. Click to Show/Hide
Mechanism Description		Additive hypotensive effects by the combination of Nitroprusside and Guanabenz

Recommended Action
Management		Management consists of carefully monitoring hemodynamics during coadministration and titrating the dosage of nitroprusside as necessary.

References
1	Product Information. Tenex (guanfacine). Wyeth-Ayerst Laboratories, Philadelphia, PA.
2	Product Information. Nipride (nitroprusside). Roche Laboratories, Nutley, NJ.
3	Cohen IM, Mottet MM, Francis GS, Alpert JS "Danger in nitroprusside therapy." Ann Intern Med 85 (1976): 205-6