The centrally acting agent clonidine and the vasodilator minoxidil are potent antihypertensives sometimes used in cases of resistant hypertension if maximal doses of more conventional agents are unsuccessful. However, this patient is not currently on optimal triple therapy, and both agents also increase the risk of orthostatic hypotension in those with autonomic neuropathy, such as this patient. Moreover, the use of minoxidil without adequate diuresis will worsen salt and water retention and should be avoided.
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- (no access) - MKSAP_17.pdf, p3407
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