Drug Name : Hydroxyzine Generic Name :hydroxyzine , hydroxyzine hydrochloride , hydroxyzine pamoate Brand Name: Oral preparations: Apo-Hydroxyzine

e (CAN), Novo-Hydroxyzine (CAN), Vistaril Parenteral preparations: Vistaril Oral preparations: Vistaril Classification: Anxiolytic, Antihistamine, Antiemetic Pregnancy Category C Dosage & Route Available forms : Tablets10, 25, 50, 100 mg; syrup10 mg/5 mL; capsules25, 50, 100 mg; oral suspension25 mg/5 mL; injection25, 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: 50100 mg qid. Management of pruritus: 25 mg tidqid. Sedative (preoperative and postoperative): 50100 mg. IM Psychiatric and emotional emergencies, including alcoholism: 50100 mg immediately and q 46 hr as needed. Nausea and vomiting: 25100 mg. Preoperative and postoperative, prepartum and postpartum: 25100 mg. PEDIATRIC PATIENTS Oral Anxiety, pruritus: o < 6 yr: 50 mg/day in divided doses. o > 6 yr: 50100 mg/day in divided doses. Sedative: 0.6 mg/kg. IM Nausea, preoperative and postoperative: 1.1 mg/kg (0.5 mg/lb). Therapeutic actions Hydroxyzine blocks histamine H1-receptors on effector cells of the GI tract, blood vessels and respiratory tract; a sedating anihistamine with antimuscarinic and significant sedative properties. It also possesses skeletal muscle relaxing, bronchodilator, antiemetic and analgesic properties. Indications Symptomatic relief of anxiety and tension associated with psychoneurosis; adjunct in organic disease states in which anxiety is manifested; alcoholism and asthma; before 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 opioid dosage, allay anxiety, and control emesis Adverse effects CNS depression, paradoxical CNS stimulation, dry mouth, thickened respiratory secretions, constipation, blurring of vision, tachycardia, GI disturbances, headache, hypotension, tinnitus. Contraindications Porphyria, neonates, pregnancy, lactation.

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 WARNING: Determine and treat underlying cause of vomiting. Drug may mask signs and symptoms of serious conditions, such as brain tumor, intestinal obstruction, or appendicitis. Do not administer parenteral solution subcutaneously, IV, or intra-arterially; tissue necrosis has occurred with subcutaneous and intra-arterial injection, and 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. You may experience these side effects: Dizziness, sedation, drowsiness (use caution if driving or performing tasks that require alertness); avoid alcohol, sedatives, sleep aids (serious overdosage could result); dry mouth (frequent mouth care, sucking on sugarless lozenges may help). Report difficulty breathing, tremors, loss of coordination, sore muscles, or muscle spasms.