PSEUDOEPHEDRINE HYDROCHLORIDE

PSEUDOEPHEDRINE HYDROCHLORIDe
(soo-doe-e-fed'rin)
Cenafed, Decongestant Syrup, Dorcol Children's Decongestant, Eltor , Eltor 120 , Halofed, Novafed, PediaCare, Pseudofrin , Robidrine , Sudafed, Sudrin
Classifications: alpha- and beta-adrenergic agonist; decongestant;
Therapeutic: decongestant

Prototype: Epinephrine
Pregnancy Category: C

Availability

30 mg, 60 mg tablets; 120 mg, 240 mg sustained release tablets; 15 mg/5 mL, 30 mg/5 mL liquid; 7.5 mg/0.8 mL drops

Action

Sympathomimetic amine that produces decongestion of respiratory tract mucosa by stimulating the sympathetic nerve endings including alpha-, beta-1, and beta-2 receptors. Also acts directly on smooth muscle and constricts renal and vertebral arteries.

Therapeutic Effect

Effective as a nasal decongestant by causing vasoconstriction and thus increasing nasal airway patency.

Uses

Symptomatic relief of nasal congestion associated with rhinitis, coryza, and sinusitis and for eustachian tube congestion.

Contraindications

Hypersensitivity to sympathomimetic amines; severe hypertension; severe coronary artery disease; use within 14 d of MAOIs; hyperthyroidism; prostatic hypertrophy; pregnancy (category C). Safe use in children <2 y is not established.

Cautious Use

Hypertension, heart disease, renal impairment; acute MI, angina; closed-angle glaucoma; concurrent use of ACE INHIBITOR.

Route & Dosage

Nasal Congestion
Adult: PO 60 mg q4–6h or 120 mg sustained release q12h
Geriatric: PO 30–60 mg q6h prn
Child: PO 2–6 y, 15 mg q4–6h (max: 60 mg/d); 6–11 y, 30 mg q4–6h (max: 120 mg/d)

Administration

Oral
  • Ensure that sustained release form is not chewed or crushed. Must be swallowed whole.

Adverse Effects (≥1%)

Body as a Whole: Transient stimulation, tremulousness, difficulty in voiding. CV: Arrhythmias, palpitation, tachycardia. CNS: Nervousness, dizziness, headache, sleeplessness, numbness of extremities. GI: Anorexia, dry mouth, nausea, vomiting.

Interactions

Drug: Other sympathomimetics increase pressor effects and toxicity; mao inhibitors may precipitate hypertensive crisis; beta blockers may increase pressor effects; may decrease antihypertensive effects of guanethidine, methyldopa, reserpine.

Pharmacokinetics

Absorption: Readily from GI tract. Onset: 15–30 min. Duration: 4–6 h (8–12 h sustained release). Distribution: Crosses placenta; distributed into breast milk. Metabolism: Partially metabolized in liver. Elimination: In urine.

Nursing Implications

Assessment & Drug Effects

  • Monitor HR and BP, especially in those with a history of cardiac disease. Report tachycardia or hypertension.

Patient & Family Education

  • Avoid taking it within 2 h of bedtime because drug may act as a stimulant.
  • Discontinue medication and consult physician if extreme restlessness or signs of sensitivity occur.
  • Consult physician before concomitant use of OTC medications; many contain ephedrine or other sympathomimetic amines and might intensify action of pseudoephedrine.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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