Home Drug Guide Acrivastine; Pseudoephedrine Hydrochloride

Drug Guide

Generic Name

Acrivastine; Pseudoephedrine Hydrochloride

Brand Names Semprex-D

Classification

Therapeutic: Allergy and Cold Relief

Pharmacological: Histamine H1 Antagonist and Sympathomimetic

FDA Approved Indications

Relief of nasal congestion, sneezing, and runny nose due to allergies or cold

Mechanism of Action

Acrivastine, an H1 antihistamine, blocks histamine receptors to reduce allergy symptoms; Pseudoephedrine is a decongestant that stimulates adrenergic receptors in nasal mucosa, causing vasoconstriction and decreasing swelling.

Dosage and Administration

Adult: Typically, 8 mg of acrivastine with 60 mg of pseudoephedrine every 4-6 hours as needed, not exceeding 4 doses in 24 hours.

Pediatric: Consult specific product guidelines; generally not recommended for children under 12 without physician oversight.

Geriatric: Adjust dosage as per clinical response; increased caution due to potential cardiovascular effects.

Renal Impairment: Use with caution; dose adjustment may be necessary.

Hepatic Impairment: Use with caution; monitor for reduced clearance.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; peak levels in 1-2 hours.

Metabolism: Metabolized in the liver (pseudoephedrine minimally metabolized).

Excretion: Excreted primarily in urine.

Half Life: Acrivastine approximately 20-24 hours; pseudoephedrine approximately 4-6 hours.

Contraindications

Allergy to any component of the drug.
Use of monoamine oxidase inhibitors (MAOIs) within the past 14 days.

Precautions

History of hypertension, heart disease, or glaucoma.
Use caution in elderly and patients with urinary retention or thyroid disease.

Adverse Reactions - Common

Drowsiness, dry mouth, dizziness (Common)
Nervousness, insomnia (Less common)

Adverse Reactions - Serious

Hypertension, tachycardia, arrhythmias (Rare)
Allergic reactions including rash, urticaria (Rare)

Drug-Drug Interactions

Monoamine oxidase inhibitors (MAOIs), other sympathomimetics, CNS depressants

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for adverse reactions such as hypertension, nervousness, or sedation.

Diagnoses:

Ineffective airway clearance related to nasal congestion.
Risk for hypertension due to pseudoephedrine.

Implementation: Administer with food to minimize gastrointestinal upset. Monitor cardiovascular status.

Evaluation: Assess relief of nasal congestion and allergy symptoms.

Patient/Family Teaching

Take medication exactly as prescribed.
Avoid operating heavy machinery until response is known.
Be aware of possible side effects such as dizziness or nervousness.
Tell your doctor if you experience palpitations or hypertension.

Special Considerations

Black Box Warnings:

Pseudoephedrine can increase blood pressure and cause cardiovascular events, caution in hypertensive patients.

Genetic Factors: Precautions in patients with genetic predispositions to drug sensitivities.

Lab Test Interference: May interfere with certain urinary assays.

Overdose Management

Signs/Symptoms: Severe hypertension, tachycardia, agitation, seizures.

Treatment: Supportive care; control blood pressure; activated charcoal if recent ingestion; consider dialysis in severe cases.

Storage and Handling

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

Stability: Stable for 2-3 years when unopened.