Home Drug Guide Dexchlorpheniramine Maleate

Drug Guide

Generic Name

Dexchlorpheniramine Maleate

Brand Names Polaramine, Polmon

Classification

Therapeutic: Antihistamine, H1 receptor antagonist

Pharmacological: First-generation antihistamine

FDA Approved Indications

  • Relief of allergic symptoms such as hay fever, conjunctivitis, allergic rhinitis, urticaria, and other allergic skin conditions

Mechanism of Action

Dexchlorpheniramine competitively blocks H1 receptors on effector cells in the gastrointestinal tract, blood vessels, and respiratory tissues, thereby counteracting the effects of endogenous histamine.

Dosage and Administration

Adult: Typically 4 mg every 4 to 6 hours as needed, not exceeding 24 mg per day

Pediatric: 2-4 mg every 4 to 6 hours, with a maximum of 12-24 mg per day depending on age and weight

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

Renal Impairment: Use with caution; dose adjustments may be necessary based on renal function

Hepatic Impairment: Use with caution; monitor for increased adverse effects; no specific dose adjustment established

Pharmacokinetics

Absorption: Well absorbed from the gastrointestinal tract

Distribution: Widely distributed in body tissues; crosses the blood-brain barrier, causing sedative effects

Metabolism: Partially metabolized in the liver

Excretion: Excreted primarily in urine

Half Life: About 14 hours, but may be prolonged in renal impairment

Contraindications

  • Known hypersensitivity to dexchlorpheniramine or other antihistamines
  • Use in neonates or premature infants

Precautions

  • May cause drowsiness; caution with activities requiring alertness
  • Prostate hypertrophy, glaucoma, hypertension, cardiovascular disease, bronchial asthma, hyperthyroidism, peptic ulcer, or urinary retention

Adverse Reactions - Common

  • Drowsiness, dry mouth, dizziness, blurred vision (Common)
  • Gastrointestinal disturbances (Uncommon)

Adverse Reactions - Serious

  • Anticholinergic effects such as urinary retention, hallucinations, or seizures (Rare)
  • Allergic reactions including rash, pruritus, or anaphylaxis (Rare)

Drug-Drug Interactions

  • CNS depressants (additive sedation)
  • Monoamine oxidase inhibitors (antihistaminic effects may be potentiated)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for allergies, monitor for sedative effects, and inquire about other medications that may cause drowsiness

Diagnoses:

  • Risk for injury related to sedation or anticholinergic effects

Implementation: Administer with food if gastric upset occurs; advise patients about sedation risks; avoid alcohol

Evaluation: Monitor symptom relief and adverse effects; reassess regularly for effectiveness and side effects

Patient/Family Teaching

  • Avoid driving or operating machinery until response is known
  • Warn about drowsiness and the potential for impairment
  • Instruct on avoiding alcohol and other CNS depressants
  • Report any signs of allergic or adverse reactions

Special Considerations

Black Box Warnings:

  • None currently

Genetic Factors: Pharmacogenomics related to CYP450 metabolism may influence drug levels (not specifically established)

Lab Test Interference: May cause false-positive results for certain diagnostic tests such as urinary catecholamines or antinuclear antibodies

Overdose Management

Signs/Symptoms: Anticholinergic toxicity, agitation, hallucinations, seizures, coma

Treatment: Supportive care, activated charcoal if ingestion was recent, thermoregulation, and symptomatic management. Physostigmine may be used in certain cases under supervision.

Storage and Handling

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

Stability: Stable under recommended storage conditions for the duration of the shelf life

🛡️ 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.