Details About Generic Salt ::  Pemoline

Main Medicine Class:: Psychotherapeutic   

(PEM-oh-leen)
Cylert
Tablets: 18.75 mg, 37.5 mg, 75 mg
Tablets, chewable: 37.5 mg
Class: Psychotherapeutic

 

Drugs Class ::

 Action Acts as a CNS stimulant but with minimal sympathomimetic effects; exact mechanism of action unknown.

Indications for Drugs ::

 Indications Treatment of attention-deficit hyperactivity disorder. Unlabeled use(s): Treatment of narcolepsy and excessive daytime sedation.

Drug Dose ::

 Route/Dosage

ADULTS AND CHILDREN 6 YR AND OLDER: PO 37.5 mg/day as a single dose in the morning initially; increase by increments of 18.75 mg weekly until desired response is obtained (max daily dose 112.5 mg/day).

Contraindication ::

 Contraindications Hepatic insufficiency.

Drug Precautions ::

 Precautions

Pregnancy: Category B. Lactation: Undetermined. Children: Safety and efficacy in children younger than 6 yr not established. Drug abuse and dependence: Can occur; use with caution in emotionally unstable patients who may increase the dosage on their own initiative. Hepatic failure: Life-threatening hepatic failure has been associated with pemoline use; therefore, pemoline is not usually considered first-line therapy. Renal impairment: Use with caution in patients with significantly impaired renal function.

PATIENT CARE CONSIDERATIONS


Drug Side Effects ::

 Adverse Reactions

CNS: Insomnia; Tourette syndrome; hallucinations; dyskinetic movements of tongue, lips, face, and extremities; abnormal oculomotor function (eg, nystagmus, oculogyric crisis); depression; dizziness; irritability; headache; drowsiness; seizures. DERM: Rash. GI: Anorexia; transient weight loss; stomach ache; nausea. HEPA: Elevated liver enzymes; hepatitis; jaundice. OTHER: Growth suppression.

Drug Mode of Action ::  

 Action Acts as a CNS stimulant but with minimal sympathomimetic effects; exact mechanism of action unknown.

Drug Interactions ::

 Interactions None well documented.

Drug Assesment ::

 Assessment/Interventions

  • Obtain patient history.
  • Clinically assess for tics and Tourette syndrome in children and their families before use of this drug.
  • Monitor growth of children during treatment, as long-term administration is associated with growth inhibition.
  • Ensure LFTs are performed prior to and periodically during therapy.
  • Assess therapeutic effects of medication. Medication is often interrupted at intervals to determine therapeutic effects and to ascertain if there are sufficient behavioral symptoms present to require continued therapy.
  • Ensure that dosage is decreased gradually following long-term therapy to prevent withdrawal symptoms.
OVERDOSAGE: SIGNS & SYMPTOMS
  Vomiting, agitation, tremors, hyperreflexia, muscle twitching, convulsions (followed by coma), euphoria, confusion, hallucinations, delirium, sweating, flushing, headache, high fever, tachycardia, hypertension, dilated pupils

Drug Storage/Management ::

 Administration/Storage

  • Do not administer if LFTs are abnormal.
  • Administer as a single dose each morning and ensure that chewable tablets are completely chewed and swallowed.
  • Administer with caution to emotionally unstable patients. Administration may intensify symptoms of behavior disturbance and thought disorder.
  • Administer with caution to patients with impaired renal function.
  • Store at controlled room temperature (56° to 86°F) in a tight, dry container.

Drug Notes ::

 Patient/Family Education

  • Advise patient that clinical improvement is gradual and benefits may not occur until wk 3 or 4 of administration.
  • Instruct patient to take pemoline as prescribed and not to make up missed doses.
  • Caution patient to avoid taking large doses of caffeine or using other stimulants that could adversely potentiate the effects of pemoline.
  • Instruct patient to take medication in the morning to avoid sleep disturbance. Notify health care provider if problems with sleeping occur.
  • Instruct patient to notify health care provider of adverse reactions; the dosage may need to be reduced or the drug discontinued.
  • Advise patient that medication can cause dizziness or drowsiness and to avoid driving and other tasks requiring mental alertness.
  • Instruct patient not to increase the dose amount or take the medication more frequently because of a high dependence and abuse potential. In addition, psychotic symptoms could occur following long-term misuse of excessive oral doses.
  • Instruct caregiver, patient, or family to be aware of the symptoms of overdose and take immediate and appropriate action, such as notifying a poison control center.
  • Instruct patient to take daily dose in the morning.
  • Advise patient to follow health care provider instructions for LFTs.
  • Advise patient to be alert for signs and symptoms of liver dysfunction (eg, jaundice, anorexia, malaise, GI complaints) and to report them immediately to the health care provider.

Disclaimer ::

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