Nurses Compass
Drug Guide
Dexbrompheniramine Maleate
Classification
Therapeutic: Antihistamine (H1 receptor antagonist)
Pharmacological: Anticholinergic, Sedative antihistamine
FDA Approved Indications
- Allergic rhinitis
- Occasional allergic conjunctivitis
- Urticaria (hives)
Mechanism of Action
Dexbrompheniramine competes with histamine for H1 receptor sites on effector cells in the gastric mucosa, vascular smooth muscle, and the respiratory mucosa, thereby reversing or preventing the effects of histamine.
Dosage and Administration
Adult: Typically 2 mg every 4-6 hours as needed, not exceeding 12 mg per day.
Pediatric: Children 6-12 years: 2 mg twice daily. Children 2-6 years: 1 mg twice daily. Pediatric doses should be adjusted based on weight and age, and under medical supervision.
Geriatric: Use with caution; start at lower end of dosing range due to increased sensitivity and risk of adverse effects.
Renal Impairment: Adjust dose accordingly; clearance may be decreased, increasing risk of toxicity.
Hepatic Impairment: Use with caution; hepatic impairment may prolong drug half-life.
Pharmacokinetics
Absorption: Rapidly absorbed from gastrointestinal tract.
Distribution: Widely distributed, crosses the blood-brain barrier.
Metabolism: Metabolized in the liver via hepatic enzymes.
Excretion: Primarily excreted in urine.
Half Life: Approximately 10-15 hours, variable depending on individual factors.
Contraindications
- Known hypersensitivity to dexbrompheniramine or other antihistamines.
- Use in caution in patients with asthma, glaucoma, urinary retention, or prostatic hypertrophy.
Precautions
- Use with caution in elderly (risk of sedation, confusion), during pregnancy and lactation, and in patients with cardiovascular diseases.
Adverse Reactions - Common
- Drowsiness (Common)
- Dizziness (Common)
- Dry mouth (Common)
- Nausea (Uncommon)
Adverse Reactions - Serious
- Seizures (Rare)
- Anaphylaxis (Rare)
- Palpitations (Uncommon)
Drug-Drug Interactions
- MAO inhibitors (risk of additive anticholinergic effects), CNS depressants (enhanced sedation)
Drug-Food Interactions
- Alcohol (enhanced sedative effects)
Drug-Herb Interactions
N/ANursing Implications
Assessment: Monitor for therapeutic response and adverse effects, especially sedation, anticholinergic effects, and respiratory status.
Diagnoses:
- Risk for sedation or CNS depression
- Potential for anticholinergic side effects
Implementation: Administer with food if gastrointestinal upset occurs; caution patients about operating vehicles or machinery.
Evaluation: Evaluate effectiveness in relieving allergy symptoms and monitor for adverse reactions.
Patient/Family Teaching
- Do not operate heavy machinery or drive until accustomed to effects.
- Avoid alcohol and CNS depressants.
- Report severe side effects such as difficulty breathing, chest tightness, or severe allergic reactions.
Special Considerations
Black Box Warnings:
- None specified for dexbrompheniramine
Genetic Factors: None known relevant to this drug.
Lab Test Interference: None known.
Overdose Management
Signs/Symptoms: Severe agitation, hallucinations, seizures, hallucinations, coma, anticholinergic signs such as dry mouth, urinary retention, blurred vision, tachycardia.
Treatment: Supportive care, activated charcoal if ingested recently, intravenous fluids, and symptomatic treatment. Consider dialysis if severe toxicity.
Storage and Handling
Storage: Store at room temperature away from light and moisture.
Stability: Stable under recommended storage conditions.