Ephedrine sulfate

[eh-FED-rin] Pregnancy Category: C Nasal decongestants: Kondon's Nasal, Pretz-D, Vatronol Nose Drops [OTC]. Systemic: Ephed II (Rx: Injection; OTC: Oral dosage forms) Classification: Adrenergic agent, direct- and indirect-acting

See also Sympathomimetic Drugs and Nasal Decongestants. Action/Kinetics: Releases norepi-nephrine from synaptic storage sites. Has direct effects on alpha, beta-1, and beta-2 receptors, causing increased BP, bronchodilation, relaxation of GI tract smooth muscle, nasal decongestion, mydriasis, and increased tone of the bladder trigone and vesicle sphincter. It may also increase skeletal muscle strength, especially in myasthenia clients. Rapidly and completely absorbed following parenteral use. Onset, IM: 10-20 min; PO: 15-60 min; SC: < 20 min. Duration, IM, SC: 30-60 min; PO: 3-5 hr. tv2, elimination: About 3 hr when urine is at a pH of 5 and about 6 hr when urinary pH is 6.3. Excreted mostly unchanged through the urine (rate dependent on urinary pH—increased in acid urine). Uses: Bronchial asthma and reversible bronchospasms associated with obstructive pulmonary diseases. Nasal congestion in vasomotor rhinitis, acute sinusitis, hay fever, and acute coryza. Parenterally to treat narcolepsy and depression. Parenterally as a vasopressor to treat shock. In acute hypotension states, especially that associated with spinal anesthesia and Stokes-Adams syndrome with complete heart block.

Additional Contraindications:

Angle closure glaucoma, anesthesia with cyclopropane or halothane, thyrotoxicosis, diabetes, obstetrics where maternal BP is greater than 130/80. Lactation.

Special Concerns: Geriatric clients may be at higher risk to develop prostatic hypertrophy. May cause hypertension resulting in intracranial hemorrhage; may also cause anginal pain in clients with coronary insufficiency or ischemic heart disease. Additional Side Effects: CNS: Nervousness, shakiness, confusion, delirium, hallucinations. Anxiety and nervousness following prolonged use. CV: Precordial pain, excessive doses may cause hypertension sufficient to result in cerebral hemorrhage. GU: Difficult and painful urination, urinary retention in males with prosta-tism, decrease in urine formation. Miscellaneous: Pallor, respiratory difficulty, hypersensitivity reactions. Abuse: Prolonged abuse can cause an anxiety state, including symptoms of paranoid schizophrenia, tachycardia, poor nutrition and hygiene, dilated pupils, cold sweat, and fever.

Additional Drug Interactions

Halothane / Serious arrhythmias due to sensitization of the myocardium to sympathomimetics by halo-thane

MAO Inhibitors / T Pressor effect ^ possible hypertensive crisis and intracranial hemorrhage How Supplied: Capsule: 24.3 mg, 25 mg, 50 mg; Injection: 50 mg/mL; Spray: 0.25%

Dosage-

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