Pseudoephedrine (d-Isoephedrine)

A to Z Drug Facts

Pseudoephedrine (d-Isoephedrine)

	Action
	Indications
	Contraindications
	Route/Dosage
	Interactions
	Lab Test Interferences
	Adverse Reactions
	Precautions
Patient Care Considerations
	Administration/Storage
	Assessment/Interventions
	Patient/Family Education

(SUE-doe-eh-FED-rin)

Allermed, Cenafed, Children's Congestion Relief, Congestion Relief, Children's Silfedrine, Decofed Syrup, Defed-60, Dorcol Children's Decongestant, Dynafed Pseudo, Efidac/24, Genaphed, Halofed, Mini Thin Pseudo, Pedia Care Infant's Decongestant, Pedia Care Nasal Decongestant, Pseudo, Pseudo-Gest, Seudotabs, Sinustop Pro, Sudafed, Sudafed 12 Hour Caplets, Sudex, Triaminic Infant Oral Decongestant Drops, Triaminic AM Decongestant Formula, Balminil Decongestant Syrup, Benylin Decongestant, PMS-Pseudoephedrine

Class: Nasal decongestant

Action Causes vasoconstriction and subsequent shrinkage of nasal mucous membranes by alpha-adrenergic stimulation, promoting nasal drainage.

Indications Relief of nasal or eustachian tube congestion.

Contraindications Hypersensitivity to sympathomimetic amines; severe hypertension; coronary artery disease; MAO inhibitor therapy; breastfeeding mothers.

Route/Dosage

PSEUDOEPHEDRINE SULFATE

ADULTS & CHILDREN > 12 YR: PO 120 mg sustained-release q 12 hr.

PSEUDOEPHEDRINE HCL

ADULTS: PO 60 mg q 4 to 6 hr or 120 mg sustained-release q 12 hr. Not to exceed 240 mg/day. CHILDREN 6 to 12 YR: PO 30 mg q 4 to 6 hr. Not to exceed 120 mg/day. CHILDREN 2 to 5 YR: PO 15 mg q 4 to 6 hr. Not to exceed 60 mg/day. CHILDREN 1 to 2 YR: PO 7 drops (0.2 ml)/kg q 4 to 6 hr. Not to exceed 4 doses/day. CHILDREN 3 to 12 MO: PO 3 drops/kg q 4 to 6 hr. Not to exceed 4 doses/day.

Interactions

Furazolidone, guanethidine, methyldopa: Increased BP. MAO inhibitors: Severe headache, hypertension and hyperpyrexia; can cause hypertensive crisis. Urinary acidifiers (eg, ammonium chloride): Increased elimination of pseudoephedrine. Urinary alkalinizers (eg, sodium bicarbonate): Decreased elimination of pseudoephedrine.

Lab Test Interferences None well documented.

Adverse Reactions

CV: Arrhythmias; cardiovascular collapse with hypotension; tachycardia; bradycardia; transient hypertension. CNS: Nervousness; excitability; dizziness; tremor; insomnia; restlessness; depression. DERM: Pallor. GI: Anorexia; nausea; vomiting; dry mouth. GU: Difficulty urinating.

Precautions

Pregnancy: Category C. Lactation: Do not give to breastfeeding mothers. Children: Use drug only under physician's advice in children < 3 mo. Elderly: Ensure that short-acting product is tolerated before giving sustained-release product. Special-risk patients: Use drug with caution in patients with hyperthyroidism, diabetes, cardiovascular disease, increased intraocular pressure or prostatic hypertrophy. Patients with hypertension should use only under medical advice. Excessive use: Systemic effects (eg, nervousness, dizziness, sleeplessness) are more common in elderly and infants.

PATIENT CARE CONSIDERATIONS

Administration/Storage

Tell patient to swallow sustained-release preparations whole, and not to break, crush or chew.
Contents of capsule may be mixed with food (eg, jelly, applesauce) if patient has difficulty swallowing.
Administer ³ 2 hr before bedtime to diminish insomnia.
Store at room temperature.

Assessment/Interventions

Obtain patient history, including drug history, special risk factors (eg, hypertension) and any known allergies. Note hypersensitivity to pseudoephedrine or other sympathomimetic amines.
Assess congestion (eg, nasal, sinus, eustachian tubes), vital signs, lung sounds and characteristics of respiratory secretions prior to and during therapy.
Provide sufficient fluid intake to liquify secretions and maintain hydration.

OVERDOSAGE: SIGNS & SYMPTOMS
	Somnolence; sedation, which may be accompanied by profuse sweating, hypotension or shock; coma. Symptoms in elderly include hallucinations, seizures, CNS depression, and death

Patient/Family Education

Advise patient not to exceed recommended dose.
Instruct patient not to chew or crush sustained-release form.
Teach patient to use calibrated measuring device to administer liquid and calibrated dropper to administer drops.
Instruct patient to report the following symptoms to physician: Breathing difficulties, hallucinations, seizures (symptoms of overdose); lack of improvement within 7 days; high fever.
Instruct patient to take sips of water frequently or suck on ice chips, sugarless hard candy or chew sugarless gum if dry mouth occurs.
Advise patient to avoid taking other otc medications containing sympathomimetic amines.