Cetirizine hydrochloride

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

·        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

·        Contraindicated with allergy to any antihistamines, hydroxyzine.

·        Use cautiously with 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; chewable tablets—5, 10 mg; syrup—5 mg/5 mL

Dosages

ADULTS AND CHILDREN > 12 YR

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

PEDIATRIC PATIENTS 6–11 YR

5 or 10 mg daily PO.

PEDIATRIC PATIENTS 2–5 YR

2.5 mg PO once daily to a maximum 5 mg/day.

PEDIATRIC PATIENTS 6 MO–2 YR

2.5 mg (one-half teaspoon) PO once daily. In children 1 yr and older, may increase to a maximum 5 mg daily given as one-half teaspoon q 12 hr.

PATIENTS WITH HEPATIC OR RENAL IMPAIRMENT

5 mg PO daily.

Pharmacokinetics

Route	Onset	Peak	Duration
Oral	Rapid	1 hr	24 hr

Metabolism: Hepatic; T_1/2: 7–10 hr

Distribution: Crosses placenta; enters breast milk

Excretion: Feces, urine

Adverse effects

·        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

·        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 examination; R, adventitious sounds; prostate palpation; renal function tests

Interventions

·        Give without regard to meals.

·        Provide syrup form or chewable tablets 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

·        Take this drug without regard to meals.

·        You may experience these side effects: 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.