Home Drug Guide Pemoline

Drug Guide

Generic Name

Pemoline

Brand Names Cylert

Classification

Therapeutic: Central nervous system stimulant, treatment of ADHD and narcolepsy

Pharmacological: Nonamphetamine stimulant

FDA Approved Indications

  • Attention deficit hyperactivity disorder (ADHD)

Mechanism of Action

Pemoline stimulates the central nervous system by increasing the release of norepinephrine and dopamine, leading to improved attention and focus.

Dosage and Administration

Adult: Initial dose of 37.5 mg once daily, titrated upward as needed; maximum dose 75 mg per day.

Pediatric: Usually started at 18.75 mg or 37.5 mg once daily, with careful monitoring.

Geriatric: Not specifically studied; use with caution due to potential for adverse effects and comorbidities.

Renal Impairment: Adjust dosage based on clinical response and tolerability.

Hepatic Impairment: Use with caution; no specific adjustment guidelines established.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed including crossing the blood-brain barrier.

Metabolism: Partially metabolized in the liver.

Excretion: Primarily excreted in urine.

Half Life: Approximately 5-8 hours.

Contraindications

  • History of tics or Tourette's syndrome.
  • History of drug abuse.
  • Previous hypersensitivity to pemoline.

Precautions

  • Monitor for signs of liver toxicity, neurotoxicity, and tics.
  • Use with caution in patients with hepatic impairment, cardiomyopathy, or hypertension.

Adverse Reactions - Common

  • Insomnia (Common)
  • Headaches (Common)
  • Nausea (Common)

Adverse Reactions - Serious

  • Hepatotoxicity (liver failure) (Rare but serious)
  • Neurotoxicity (tics, hallucinations) (Rare)
  • Cardiovascular events (hypertension, tachycardia) (Less common)

Drug-Drug Interactions

  • MAO inhibitors (risk of hypertensive crisis)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor liver function tests, blood pressure, heart rate, and signs of neurotoxicity and tics.

Diagnoses:

  • Risk for liver toxicity
  • Ineffective coping related to neurobehavioral side effects

Implementation: Administer as prescribed, monitor for adverse effects, counsel patient on signs of liver problems.

Evaluation: Assess for therapeutic effectiveness and adverse effects; perform regular liver function tests.

Patient/Family Teaching

  • Report any signs of liver problems: jaundice, dark urine, abdominal pain.
  • Do not abruptly stop medication.
  • Be aware of potential neurobehavioral changes and report them.

Special Considerations

Black Box Warnings:

  • Potential for hepatotoxicity leading to liver failure

Genetic Factors: None specifically noted

Lab Test Interference: No known interference

Overdose Management

Signs/Symptoms: Nausea, vomiting, agitation, tremors, hallucinations, seizures, liver failure signs such as jaundice, elevated liver enzymes.

Treatment: Supportive care, activated charcoal if ingestion was recent, liver function monitoring, and hospitalization as needed.

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.