Question

A chronic smoker was on nicotine replacement therapy and clonidine tablets for smokingde-addiction. He stopped taking clonidine tablets and now presents with a headache. What is the reason behind this condition?

• A. Postural hypotension
• B. Receptor upregulation
• C. Rebound hypertension
• D. Receptor hypersensitivity

Answer 1

The Correct Option is C

The patient in question was undergoing nicotine replacement therapy alongside clonidine tablets for smoking cessation. Clonidine is a centrally acting alpha-2 adrenergic agonist often used to treat hypertension. Its mechanism involves reducing sympathetic outflow from the central nervous system, thereby decreasing blood pressure. When clonidine is abruptly discontinued, the body experiences a sudden surge in sympathetic activity, as the drug's inhibitory effects on the sympathetic nervous system are removed. This surge can lead to a sharp rise in blood pressure, known as rebound hypertension.

Let's break down the reasoning:

• Clonidine Action: Clonidine decreases sympathetic nerve signals, leading to lower blood pressure.
• Discontinuation Effects: Sudden cessation can cause a rebound effect where blood pressure spikes.
• Clinical Presentation: A headache is a common symptom associated with such a rise in blood pressure.

The most suitable explanation for the headache is therefore due to rebound hypertension following the abrupt discontinuation of clonidine.