Pemoline

Oral
Hyperactivity disorders

Liver impairment; children <6 yr; Tourette's syndrome; psychosis.

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.

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.

PO: B

Anorexia, choreoathetosis, dyskinesias, elevated LFTs, exacerbation of Tourette's syndrome, hallucinations, hyperthermia, insomnia, leukocytosis, mania, mydriasis, neutropenia, nystagmus, rhabdomyolysis, stuttering, vomiting.

Hypertensive crisis with MAOIs. Reduced seizure threshold in epileptic patients on antiepileptics.

Interferes with tests for prostatic acid phosphatase used in prostatic carcinoma diagnosis; produces false acid phosphatase elevations.

Description:
Mechanism of Action: 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.

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