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chlorpheniramine

(klor-fen-ir-a-meen) ,

Aller-Chlor

(trade name),

Allergy

(trade name),

Chlo-Amine

(trade name),

Chlorate

(trade name),

Chlor-Trimeton

(trade name),

Chlor-Trimeton Allergy 4 Hour

(trade name),

Chlor-Trimeton Allergy 8 Hour

(trade name),

Chlor-Trimeton Allergy 12 Hour

(trade name),

Chlor-Tripolon

(trade name),

PediaCare Allergy Formula

(trade name),

Phenetron

(trade name),

Telechlor

(trade name),

Teldrin

(trade name)

Classification

Therapeutic: allergy cold cough remedies
Pregnancy Category: B

Indications

Relief of allergic symptoms caused by histamine release, including:
  • Nasal allergies,
  • Allergic dermatoses.
Management of severe allergic or hypersensitivity reactions, including anaphylaxis and transfusion reactions.

Action

Antagonizes the effects of histamine at H2-receptor sites; does not bind to or inactivate histamine.

Therapeutic effects

Decreased symptoms of histamine excess (sneezing, rhinorrhea, nasal and ocular pruritus, ocular tearing, and redness).

Pharmacokinetics

Absorption: Well absorbed following oral and parenteral administration.
Distribution: Widely distributed. Minimal amounts excreted in breast milk. Crosses the blood-brain barrier.
Metabolism and Excretion: Extensively metabolized by the liver.
Half-life: 12–15 hr.

Time/action profile (antihistaminic effects)

ROUTEONSETPEAKDURATION
PO15–30 min6 hr4–12 hr
PO–ERunknownunknown8–24 hr
Subcutunknownunknown4–12 hr
IMunknownunknown4–12 hr
IVrapidunknown4–12 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity; Acute attacks of asthma; Lactation: Avoid use or use alternative feeding method; Known alcohol intolerance (some liquid forms); Pediatric: Children <4 yr (OTC cough and cold products containing this medication should be avoided).
Use Cautiously in: Angle-closure glaucoma; Liver disease; Geriatric: Appears on Beers list. Geriatric patients are more susceptible to adverse reactions due to anticholinergic effects; Obstetric: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • drowsiness (most frequent)
  • dizziness
  • excitation (in children)

Ear, Eye, Nose, Throat

  • blurred vision (most frequent)

Cardiovascular

  • hypertension (most frequent)
  • arrhythmias
  • hypotension
  • palpitations

Gastrointestinal

  • dry mouth (most frequent)
  • constipation
  • obstruction

Genitourinary

  • retention
  • urinary hesitancy

Interactions

Drug-Drug interaction

↑ CNS depression with other CNS depressants, including alcohol, opioid analgesics, and sedative/hypnotics.MAO inhibitors intensify and prolong anticholinergic effects of antihistamines.↑ anticholinergic effects with other drugs possessing anticholinergic properties, including antidepressants, atropine, haloperidol, phenothiazines, quinidine, and disopyramide.

Route/Dosage

Oral (Adults) 4 mg q 4–6 hr or 8–12 mg of extended-release formulation q 8–12 hr (not to exceed 24 mg/day).
Oral (Geriatric Patients) 4 mg twice daily or 8 mg of extended-release formulation at bedtime.
Oral (Children 6–12 yr) 2 mg 3–4 times daily (not to exceed 12 mg/day).
Injectable formulation is available only in Canada
Subcutaneous Intramuscular Intravenous (Adults) 5–40-mg single dose (not to exceed 40 mg/day).
Subcutaneous (Children) 87.5 mcg (0.0875 mg)/kg or 2.5 mg/m2 q 6 hr as needed.

Availability (generic available)

Tablets: 4 mgRx, OTC, 8 mgRx, OTC, 12 mgRx, OTC
Chewable tabletsorange flavor: 2 mgRx, OTC
Timed-release tablets: 8 mgRx, OTC, 12 mgRx, OTC
Timed-release capsules: 8 mgRx, OTC, 12 mgRx, OTC
Syrup: 1 mg/5 mLRx, OTC, 2 mg/5 mLRx, OTC
Injection: 10 mg/mL, 100 mg/mL
In combination with: hydrocodone (Tussionex),, hydrocodone and pseudoephedrine (Zutripro), and decongestantsRx, OTC. See combination drugs.

Nursing implications

Nursing assessment

  • Assess allergy symptoms (rhinitis, conjunctivitis, hives) prior to and periodically during therapy.
  • Monitor pulse and BP before initiating and throughout IV therapy.
  • Geriatric: Assess for adverse anticholinergic effects (delirium, acute confusion, dizziness, dry mouth, blurred vision, urinary retention, constipation, tachycardia).
  • Assess lung sounds and character of bronchial secretions. Maintain fluid intake of 1500–2000 mL/day to decrease viscosity of secretions.
  • Lab Test Considerations: May cause false-negative reactions on allergy skin tests; discontinue 4 days prior to testing.

Potential Nursing Diagnoses

Ineffective airway clearance (Indications)
Risk for injury (Adverse Reactions)

Implementation

  • Oral: Administer oral doses with food or milk to decrease GI irritation. Extended-release tablets and capsules should be swallowed whole; do not crush, break, or chew. Chewable tablets should not be swallowed whole; chew well before swallowing.
  • Subcutaneous: Intramuscular: The 100-mg/mL solution is recommended for IM or subcut routes only. The 10-mg/mL solution may be used for IM, subcut, or IV.
  • Intravenous Administration
  • pH: No Data.
  • Diluent: May be given undiluted. Use only the 10 mg/mL strength for IV administration. Concentration: 10 mg/mL.
  • Rate: Administer each 10-mg dose over at least 1 min.

Patient/Family Teaching

  • Instruct patient to take chlorpheniramine as directed.
  • Caution parents to avoid OTC cough and cold products while breastfeeding or to children <4 yrs.
  • Geriatric: Teach patient and family about anticholinergic effects and to contact health care professional if effects persist.
  • May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to drug is known.
  • Caution patient to avoid using alcohol or other CNS depressants concurrently with this drug.
  • Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may help relieve dryness of mouth.
  • Instruct patient to contact health care professional if symptoms persist.

Evaluation/Desired Outcomes

  • Decrease in allergic symptoms.

chlo·rate

(klōr'āt),
A salt of chloric acid.

chlo·rate

(klōr'āt)
A salt of chloric acid.

chlorate

as sodium or potassium chlorate, one of the original chemical herbicides but now largely superseded. Animals may be poisoned if they eat pasture or plant contaminated by the spray or the dry powder. It may also be administered accidentally because of its similarity to sodium chloride. Causes gastroenteritis with diarrhea, nitrite poisoning with anoxia and intravascular hemolysis resulting in anemic anoxia.
References in periodicals archive ?
01 M potassium chlorate or 3% hydrogen peroxide was placed in the center of each area and allowed to dry for 5 h.
The intensity of the red-brown color increased with increasing chlorate ion concentration.
These swabs were totally ineffective at screening chlorate residues from the surface no matter how long they were allowed to develop.
The addition of water spray to the procedure significantly reduced development times to 5 min for indicator #2 detecting peroxide residues and to 3 min for indicator #1 detecting chlorate residues.
The Drop-Ex Plus kit was able to successfully screen all chlorate and peroxide residues on the surface.