Home Drug Guide Hydrocodone Polistirex and Chlorpheniramine Polistirex

Drug Guide

Generic Name

Hydrocodone Polistirex and Chlorpheniramine Polistirex

Brand Names Tussionex Pennkinetic, Tussicaps

Classification

Therapeutic: Cough suppressant/antihistamine combination

Pharmacological: Opioid analgesic/antihistamine

FDA Approved Indications

  • Relief of cough and upper respiratory symptoms associated with allergic or non-allergic rhinitis, sinusitis, or common cold

Mechanism of Action

Hydrocodone, an opioid agonist, suppresses cough reflex in the brainstem; Chlorpheniramine, an antihistamine, blocks H1 receptors reducing allergy symptoms and also has anticholinergic effects.

Dosage and Administration

Adult: As prescribed, typically every 12 hours; monitor for dose adjustments based on response and tolerability.

Pediatric: Not recommended for children under 6 years due to risk of respiratory depression.

Geriatric: Start with lower dose; closely monitor due to increased sensitivity and potential for side effects.

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

Hepatic Impairment: Use with caution; adjust dose based on hepatic function.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Hydrocodone primarily metabolized in the liver via CYP450 enzymes; chlorpheniramine undergoes hepatic metabolism.

Excretion: Renal excretion of metabolites; half-life approximately 4-6 hours for hydrocodone, slightly longer in hepatic impairment.

Half Life: Hydrocodone: approximately 3.8 hours, extended with polistirex formulation.

Contraindications

  • hypersensitivity to opioid or antihistamine components
  • children under 6 years
  • respiratory depression or severe respiratory compromise

Precautions

  • Use cautiously in patients with history of substance abuse, hepatic or renal impairment, respiratory depression, or head injury. Pregnancy category C; use only if clearly needed.

Adverse Reactions - Common

  • Drowsiness, dizziness (Common)
  • Dry mouth, nausea (Common)
  • Constipation, urinary retention (Common)

Adverse Reactions - Serious

  • Respiratory depression (Serious (rare))
  • High or low blood pressure, arrhythmias (Serious)
  • Dependence, addiction (Serious)

Drug-Drug Interactions

  • CNS depressants, other sedatives, alcohol, MAO inhibitors, serotonergic drugs

Drug-Food Interactions

  • Alcohol, sedatives

Drug-Herb Interactions

  • St. John’s Wort, Kava, Valerian

Nursing Implications

Assessment: Monitor respiratory status, level of sedation, and bowel function.

Diagnoses:

  • Risk for respiratory depression
  • Ineffective airway clearance
  • Risk for constipation

Implementation: Administer with food if tolerated; avoid alcohol and sedatives; instruct patient on safety precautions.

Evaluation: Assess for relief of cough and allergy symptoms; monitor for adverse effects and dependence.

Patient/Family Teaching

  • Do not operate heavy machinery or drive until response is known.
  • Avoid alcohol and sedatives.
  • Report new or worsening symptoms, especially respiratory depression.
  • Use as directed; do not exceed prescribed dose.

Special Considerations

Black Box Warnings:

  • Potential for addiction, abuse, and misuse; respiratory depression, especially in children and in those not opioid-tolerant.

Genetic Factors: Variability in CYP2D6 metabolism can affect hydrocodone efficacy and safety.

Lab Test Interference: None significant reported.

Overdose Management

Signs/Symptoms: Respiratory depression, somnolence, miosis, coma.

Treatment: Supportive care; administer naloxone if respiratory depression persists or is severe; ensure airway patency, administer oxygen, and provide symptomatic treatment.

Storage and Handling

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

Stability: Stable for the duration of the expiration date on the package.

🛡️ 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.