Pseudoephedrine For Pharmacy Techs

Pseudoephedrine is a sympathomimetic drug which is commonly used in decongestants.

It aides in the attenuation of blood vessels primarily in the nasal cavity.

Nasal congestion, or also commonly known as stuffy nose, is caused due to widened blood vessels, and this is where pseudoephedrine comes into play—it reverses this condition.

It comes from the phenthylamine and amphetamine chemical classes and is widely used in products such as Sudafed, Q-Fed, Sudogest and many more.

There are several warnings related to consuming Pseudoephedrine, and the first and foremost is to make sure that patients check the ingredients list of the product to see if they are allergic to anything in it, or even to pseudoephedrine itself.

The patient should get clearance from their doctor if they have glaucoma, high blood pressure, diabetes, thyroid problems, difficulty urinating, heart disease, or digestive system problems.

They should also seek their doctor's clearance if they are pregnant or breastfeeding.

If the patient is scheduled for surgery in the near future, urge them to inform the surgeon, as pseudoephedrine could cause complications with anesthesia.

In the case of pseudoephedrine overdose, medical attention should be sought as soon as possible. Signs of overdose: the patient will start to feel worsening side effects (see further down this page for side effects) of the pseudoephedrine.

This usually happens when someone has missed their dose and then doubled the dosage to make up the missed dose or it may happen if they’ve forgetten they've already taken a dose.

While on pseudoephedrine, patients be sure to avoid products in the monoamine oxidase inhibitor (MAO inhibitor) medication class.

This class includes the following drugs:

  • Marplan (isocarboxazid),
  • Nardil (phenelzine),
  • Emsam,
  • Eldepryl,
  • Zelapar (selegiline),
  • and Parnate (tranclycypromine.)

The patients’ last dose of a MOA inhibitor must have been stopped at least two weeks prior to beginning pseudoephedrine. The MOA inhibitor compounds are usually found in antidepressant drugs used to treat depression.

Caffeine and any/all type(s) of caffeine pills should be avoided. Stimulant medication, like ADHD meds, must not be taken in order to avoid very bad side effects. Some over-the-counter medicines used to treat cough and cold symptoms may already contain pseudoephedrine; if patients are taking them co-currently with other medicine, an overdose may occur.

Refer patients to the pharmacist in the case of questions about interactions between pseudoephedrine and other medications.

Pseudoephedrine can interact with the beta-blocker class of blood pressure medications. Specifically, it may interact with the following beta-blockers:

  • atenolol,
  • metoprolol,
  • carteolol,
  • nadolol,
  • stalol,
  • propanolol,
  • and timolol.

It also may interact with other heart disease medications and also medications used to treat migraine headaches.

There are other drugs that could interact and worsen a patient’s condition or cause complications, therefore you should always recommend that patients discuss questions with their pharmacist or seek their doctor's advice when beginning treatment with pseudoephedrine.

If the patient is experiencing side effects since starting pseudoephedrine, ask them if they would like to discuss it with a pharmacist. If not, urge them to seek help from their doctor, especially when their symptoms are really bad, or do not go away. Milder side effects which may be experienced include:

  • restlessness,
  • nausea and/or vomiting,
  • lethargy,
  • weakness,
  • and headaches.

However, there are more serious side effects; these may include:

  • nervousness,
  • insomnia,
  • dizziness,
  • difficulty breathing,
  • stomach problems,
  • and tachycardia (a fast, irregular or pounding heartbeat.)

There are many of forms of pseudoephedrine, such as 12-hour extended-release tablets, 24-hour extended-release tablets, or even liquid solutions. It also comes in various formulations, which combines other drugs and chemicals as well.

Patients should always be sure to seek their doctor's advice (or the pharmacists advice) before starting pseudoephedrine medication and always follow the recommended dosage printed on the back of the box unless otherwise instructed by a healthcare professional.

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