Hyperactivity disorders
Child: Initially 37.5 mg daily in the morning, increase at wkly intervals by 18.75 mg. Usual dose: 56.25-75 mg/day; max dose: 112.5 mg/day.
Indications and Dosage
Oral
Hyperactivity disorders Child: Initially 37.5 mg daily in the morning, increase at wkly intervals by 18.75 mg. Usual dose: 56.25-75 mg/day; max dose: 112.5 mg/day.
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Contraindications
Liver impairment; children <6 yr; Tourette's syndrome; psychosis.
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Special Precautions
Should only be started in patients with normal baseline LFTs; monitor LFTs every 2 wk. Discontinue if serum alanine aminotransferase is increased, if signs of liver failure develop or if no substantial clinical response within 3 wk of completing dose titration. Renal dysfunction, psychosis, bipolar disorder, DM, cardiovascular disease, seizure disorders, insomnia, porphyria, or hypertension. Potential for drug dependency. Avoid abrupt withdrawal in chronic patients. May impair ability to drive or operate machinery. Pregnancy and lactation.
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Adverse Reactions
Insomnia, night terrors, nervousness, restlessness, irritability, euphoria, fatigue and depression; dryness of the mouth, anorexia, abdominal cramps and other GI disturbances; headache, dizziness, tremor, sweating, tachycardia, palpitations, MI, hypertension or hypotension, altered libido, and impotence. Possible growth suppression in children.
Potentially Fatal: Hepatotoxicity. |
Overdosage
Anorexia, choreoathetosis, dyskinesias, elevated LFTs, exacerbation of Tourette's syndrome, hallucinations, hyperthermia, insomnia, leukocytosis, mania, mydriasis, neutropenia, nystagmus, rhabdomyolysis, stuttering, vomiting.
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Drug Interactions
Hypertensive crisis with MAOIs. Reduced seizure threshold in epileptic patients on antiepileptics.
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Lab Interference
Interferes with tests for prostatic acid phosphatase used in prostatic carcinoma diagnosis; produces false acid phosphatase elevations.
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Action
Description: Pemoline is a CNS stimulant. It is an indirect-acting sympathomimetic with alpha- and beta-adrenergic agonist activity.
Onset: Peak effect: 4 hr Duration: 8 hr Pharmacokinetics: Absorption: Readily absorbed from the GI tract. Distribution: Approx 50% bound to plasma proteins. Metabolism: Hepatic. Excretion: Via urine, faeces (negligible amounts). Half-life elimination: Children: 7-8.6 hr; adults: 12 hr. |
MIMS Class
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