A patient with allergic rhinitis is taking a compound product of loratadine/pseudoephedrine (Claritin-D) every 12 hours. The patient complains of insomnia. The nurse notes that the patient is restless and anxious
The patient's heart rate is 90 beats per minute, and the blood pressure is 130/85 mm Hg. The nurse will contact the provider to:
a. discuss using an intranasal glucocorticoid and loratadine (Claritin).
b. report acute toxicity caused by pseudoephedrine.
c. suggest using an agent with a sympathomimetic drug only.
d. suggest using a topical decongestant to minimize systemic symptoms.
ANS: A
This patient is showing central nervous system (CNS) and cardiovascular side effects of the pseudoephedrine. A better option would be to use single-ingredient products for each symptom; an intranasal glucocorticoids and an oral antihistamine are considered first-line treatments. This patient is demonstrating adverse effects but not acute toxicity. Using a sympathomimetic agent would increase the adverse effects, because pseudoephedrine is a sympathomimetic drug. Topical decongestants are not first-line drugs for allergic rhinitis.
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