Drug Guide

Generic Name

Dexbrompheniramine Maleate

Brand Names Disomer

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/A

Nursing 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.

🛡️ 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.