Home Drug Guide Mecamylamine Hydrochloride

Drug Guide

Generic Name

Mecamylamine Hydrochloride

Brand Names Inversine

Classification

Therapeutic: Antihypertensive, Nicotinic Antagonist

Pharmacological: Non-selective Ganglionic Blocker

FDA Approved Indications

  • Hypertension (off-label use commonly for nicotine addiction or other conditions)

Mechanism of Action

Mecamylamine is a non-selective antagonist of nicotinic acetylcholine receptors at autonomic ganglia, leading to inhibition of sympathetic and parasympathetic neurotransmission, which results in lowered blood pressure.

Dosage and Administration

Adult: Typically, 10-30 mg per day in divided doses, titrated based on response and tolerability.

Pediatric: Use is generally not recommended due to limited data.

Geriatric: Start at lower doses due to increased sensitivity and risk of side effects.

Renal Impairment: Use with caution; dosage adjustments may be necessary.

Hepatic Impairment: Use with caution; monitor closely.

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Metabolized minimally in the liver.

Excretion: Excreted primarily via kidneys in unchanged form.

Half Life: Approximately 10-24 hours, allowing for once or twice daily dosing.

Contraindications

  • Known hypersensitivity to mecamylamine or other ganglionic blockers.

Precautions

  • Use with caution in patients with psychiatric disorders, cardiovascular disease, or history of cerebrovascular disease.

Adverse Reactions - Common

  • Orthostatic hypotension (Common)
  • Headache (Common)
  • Dizziness (Common)

Adverse Reactions - Serious

  • Neuropsychiatric symptoms (depression, hallucinations) (Less common)
  • Gastrointestinal disturbances (nausea, vomiting) (Less common)
  • Severe hypotension or hypertensive crisis in overdose (Serious)

Drug-Drug Interactions

  • Other antihypertensives (additive hypotension)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor blood pressure, heart rate, mental status, and signs of autonomic dysfunction.

Diagnoses:

  • Risk for falls due to hypotension
  • Impaired sleep or mood disturbances

Implementation: Administer as prescribed, monitor vitals regularly, assess for side effects.

Evaluation: Evaluate blood pressure control and adverse effects.

Patient/Family Teaching

  • Do not stop medication abruptly.
  • Rise slowly from sitting or lying position to prevent orthostatic hypotension.
  • Report any mental changes, severe dizziness, or signs of depression.

Special Considerations

Black Box Warnings:

  • Use with caution in patients with psychiatric disorders.
  • Monitor for neuropsychiatric adverse effects.

Genetic Factors: None established.

Lab Test Interference: May cause false positives in certain drug screening tests for nicotine.

Overdose Management

Signs/Symptoms: Severe hypotension, coma, muscle weakness, sedation.

Treatment: Supportive care, intravenous fluids, vasopressors if needed, activated charcoal if ingestion was recent.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.