Cetirizine Hydro Chloride

cetirizine hydrochloride (se teer' i zeen) Reactine (CAN), Zyrtec Pregnancy Category B Drug class

Antihistamine Therapeutic actions

Potent histamine (H1) receptor antagonist; inhibits histamine release and eosinophil chemotaxis during inflammation, leading to reduced swelling and decreased inflammatory response Indications

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Management of seasonal and perennial allergic rhinitis Treatment of chronic, idiopathic urticaria Treatment of year-round allergic rhinitis and chronic idiopathis urticaria in infants > 6 mo

Contraindications and cautions

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Contraindicated with allergy to any antihistamines, hydroxyzine; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack, bladder neck obstruction, pyloroduodenal obstruction (avoid use or use with caution as condition may be exacerbated by drug effects); lactation

Available forms

Tablets—5, 10 mg; syrup—5 mg/5 mL Dosages ADULTS

5–10 mg daily PO; maximum dose 20 mg/day. PEDIATRIC PATIENTS

6 mo–5 yr: 2.5 mg (one-half teaspoon) PO once daily. In children 1 yr and older, may increase to maximum 5 mg daily given as one-half teaspoon q 12 hr. 6–11 yr: 5 or 10 mg daily PO. > 12 yr: Use adult dosage. PATIENTS WITH HEPATIC OR RENAL IMPAIRMENT

5 mg PO daily. Pharmacokinetics Route Oral

Onset Rapid

Peak 1 hr

Duration 24 hr

Metabolism: Hepatic; T1/2: 7–10 hr Distribution: Crosses placenta; enters breast milk Excretion: Urine and feces

Adverse effects

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CNS: Somnolence, sedation CV: Palpitation, edema GI: Nausea, diarrhea, abdominal pain, constipation Respiratory: Bronchospasm, pharyngitis Other: Fever, photosensitivity, rash, myalgia, arthralgia, angioedema

Nursing considerations CLINICAL ALERT!

Name confusion has occurred between Zyrtec (cetirizine) and Zyprexa (olanzapine); use caution. Assessment

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History: Allergy to any antihistamines, hydroxyzine; narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy, asthmatic attack, bladder neck obstruction, pyloroduodenal obstruction; lactation Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision exam; R, adventitious sounds; prostate palpation; renal function tests

Interventions

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Give without regard to meals. Provide syrup form for pediatric use if needed. Arrange for use of humidifier if thickening of secretions, nasal dryness become bothersome; encourage adequate intake of fluids. Provide skin care for urticaria.

Teaching points

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Take this drug without regard to meals. These side effects may occur: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); thickening of bronchial secretions, dryness of nasal mucosa (humidifier may help). Report difficulty breathing, hallucinations, tremors, loss of coordination, irregular heartbeat.

Adverse effects in Italic are most common; those in Bold are life-threatening.