Hydroxyzine is an oral and injectable anxiolytic, antihistamine, and antiemetic that works by suppressing areas of the central nervous system and has antihistaminic, analgesic, antispasmodic, antiemetic, and bronchodilator properties used for treating anxiety, pruritus, nausea, and vomiting with dosages varying based on age, route, and condition; it has potential adverse effects like drowsiness, involuntary movements, and hypersensitivity reactions.
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Hydroxyzine is an oral and injectable anxiolytic, antihistamine, and antiemetic that works by suppressing areas of the central nervous system and has antihistaminic, analgesic, antispasmodic, antiemetic, and bronchodilator properties used for treating anxiety, pruritus, nausea, and vomiting with dosages varying based on age, route, and condition; it has potential adverse effects like drowsiness, involuntary movements, and hypersensitivity reactions.
Hydroxyzine is an oral and injectable anxiolytic, antihistamine, and antiemetic that works by suppressing areas of the central nervous system and has antihistaminic, analgesic, antispasmodic, antiemetic, and bronchodilator properties used for treating anxiety, pruritus, nausea, and vomiting with dosages varying based on age, route, and condition; it has potential adverse effects like drowsiness, involuntary movements, and hypersensitivity reactions.
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Hydroxyzine is an oral and injectable anxiolytic, antihistamine, and antiemetic that works by suppressing areas of the central nervous system and has antihistaminic, analgesic, antispasmodic, antiemetic, and bronchodilator properties used for treating anxiety, pruritus, nausea, and vomiting with dosages varying based on age, route, and condition; it has potential adverse effects like drowsiness, involuntary movements, and hypersensitivity reactions.
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Therapeutic actions Mechanisms of action not understood; actions may be due to suppression of subcortical areas of the CNS; has clinically demonstrated antihistaminic, analgesic, antispasmodic, antiemetic, mild antisecretory, and bronchodilator activity
Indications • Symptomatic relief of anxiety and tension associated with psychoneurosis; adjunct in organic disease states in which anxiety is manifested; alcoholism and asthma; prior to dental procedures • Management of pruritus due to allergic conditions, such as chronic urticaria, atopic and contact dermatosis, and in histamine-mediated pruritus • Sedation when used as premedication and following general anesthesia • Control of nausea and vomiting and as adjunct to analgesia preoperatively and postoperatively (parenteral) to allow decreased opioid dosage • IM administration: Management of the acutely disturbed or hysterical patient; the acute or chronic alcoholic with anxiety withdrawal symptoms or delirium tremens; as preoperative and postoperative and prepartum and postpartum adjunctive medication to permit reduction in narcotic dosage, allay anxiety, and control emesis
Contraindications and cautions
• Contraindicated with allergy to hydroxyzine, pregnancy, lactation. • Use cautiously with uncomplicated vomiting in children (may contribute to Reye's syndrome or unfavorably influence its outcome; extrapyramidal effects may obscure diagnosis of Reye's syndrome). Available forms Tablets—10, 25, 50, 100 mg; syrup—10 mg/5 mL; capsules—25, 50, 100 mg; oral suspension—25 mg/5 mL; injection—25, 50 mg/mL
Dosages Start patients on IM therapy when indicated; use oral therapy for maintenance. Adjust dosage to patient's response. ADULTS Oral • Symptomatic relief of anxiety: 50–100 mg qid. • Management of pruritus: 25 mg tid–qid. • Sedative (preoperative and postoperative): 50–100 mg. IM • Psychiatric and emotional emergencies, including alcoholism: 50–100 mg immediately and q 4–6 hr as needed. • Nausea and vomiting: 25–100 mg. • Preoperative and postoperative, prepartum and postpartum: 25–100 mg. PEDIATRIC PATIENTS Oral • Anxiety, pruritus: < 6 yr: 50 mg/day in divided doses. > 6 yr: 50–100 mg/day in divided doses. • Sedative: 0.6 mg/kg. IM • Nausea, preoperative and postoperative: 1.1 mg/kg (0.5 mg/lb).
Pharmacokinetics Route Onset Peak Duration Oral, IM 15–30 min 3 hr 4–6 hr
Metabolism: Hepatic; T1/2: 3 hr
Distribution: Crosses placenta; may enter breast milk Excretion: Urine
Adverse effects • CNS: Drowsiness, involuntary motor activity, including tremor and seizures • GI: Dry mouth • Hypersensitivity: Wheezing, dyspnea, chest tightness
Nursing considerations Assessment • History: Allergy to hydroxyzine or cetirizine, uncomplicated vomiting in children, lactation, pregnancy • Physical: Skin color, lesions, texture; orientation, reflexes, affect; R, adventitious sounds Interventions • Determine and treat underlying cause of vomiting. Drug may mask signs and symptoms of serious conditions, such as brain tumor, intestinal obstruction, appendicitis. • Do not administer parenteral solution SC, IV, or intra-arterially; tissue necrosis has occurred with SC and intra-arterial injection, hemolysis with IV injection. • Give IM injections deep into a large muscle. In adults, use upper outer quadrant of buttocks or midlateral thigh; in children use midlateral thigh muscles; use deltoid area only if well developed.
Teaching points • Take this drug as prescribed. Avoid excessive dosage. • These side effects may occur: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); avoid alcohol, sedatives, sleep aids (serious overdosage could result); dry mouth (use frequent mouth care; suck sugarless lozenges). • Report difficulty breathing, tremors, loss of coordination, sore muscles, or muscle spasms.
Adverse effects in Italic are most common; those in Bold are life-threatening.
