Drug Interaction:
Chlorpheneramine maleate -
Potentiates sedative effects of psychotic drugs eg, barbiturates, hypnotics, opoid analgesics,anioolytic and antipsychotics.
Interaction with alcohol could be dangerous (sedation/excitation)
Pseudoephedrine-
increased risk of HTN and arrhythmias, if given with cardiac glycosides, quinidine or TCAs
increased risk of vasoconstritor effects if given with ergot alkaloids or oxytocin
Co- admin with MAOI may cause hypetensive crisis.
Anesthetic eg. cyclopropane, halothane, and other halogenated anesthetics , antihypertensive agents
Phenylpropranolamine-
Decreased theophylline clearance with phenylpropranolamine
Increased risk of potentially fatal hypertensive crisis with or within 14 days after stopping MAOIs.
Increased side effects with bromocriptine
Indication:
Nasal congestion
Adverse Reaction:
Chorpheneramine maleate-
CNS depressin, sedation, drowsiness, lassitude, dizziness, GI upset, anorexia, or increased appetite epigastric pain, blurring of vision, dysuria, dryness of mouth, lightness of chest, hypotension, muscular weakness, tinnitus, euphoria, headache, paradoxical CNS stimulation CV collapse and respiratory failure
Pseudoephidrine- Anginal pain, rebound congrstion, and rhinorrhea, tremor , insomnia, confusion, Irritability, and psychotic states, reduced appitite, Nausea, vomiting, gangrene, cerebral haemorrhage, andpulmonary oedema, Reflux bradycardia, cardiac arrythmias, paplitations, cardiac arrest, Hypotension, dizziness, fainting and flushing Tissue necrosis, and sloughing, myocardial and artrerial necrosis
Phenylpropanolamine- Palpitations, hypertension, anxiety, restlessness, insomnia, dizziness, anxiety agitation. Tremors, confusion, Hypertensive crisis, hemorrhagic stroke.
Contra-Indications:
Chorpheneramine maleate-
Hypersensitivity, neonates
Special precautions-
Elderly
pylori duodenal obstruction, angle-closure glaucoma, urinary retention, prostic hyperplasia,
epilepsy. renal and hepatic impairment,
May affect performance of skilled tasks.
BPH bladder ndech obstruction, hypertension
Pregnancy
Lactation
Pseudoephedrine-
Severe hypertension, phaechromocytoma
Special Precaution-
Hyperthyroidism, ischaemic heart disease, arrhythmias, or tachycardia,
occlusive vascular disorders eg. arteriosclerosis
HTN or aneurysms, DM or closed angle- glaucoma, renal impairment,
prostatic enlargement,
Pregnancy
Lactation
Phenylpropanolamine-
Concurrent use or within 14 days after stopping MAOIs
Special precautions-
Hyperthroidism, DM, ischemic heart disease, hypertension, renal impairment or
angle closure glaucoma
Patients who are overweight or eating disorders
Pregnancy
Laction
Elderly
Dosages/ Overdosage Etc:
Nasal congestion
Cholrphenermine maleate-
4mg every 4-6 hours
Max- 24mg
Child 1 yr- 1mg bid
2-5 yr 1mg every 4-6 hr
6-12 yr 2mg every 4-6 hr
Max - 6mg daily 1-5 yr
12mg daily 6-12 yr
Pseudoephidrine-
as HCl or sulphate - 60mg every 4-6 hr
Max dose 4 doses in 24hr
Child- as hcl or suphate -
2-6 yr- 15mg 3-4 times daily
6-12 yr - 30mg 3-4 times daily
Pregnancy and lactation:
Contraindicated for use during pregnancy or lactation. Use with caution