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(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.

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