Enter the terms you wish to search for. Ban IV use of promethazine: 2.4: 3: Remove promethazine from the formulary: 2.3: 3: While about two-thirds of all respondents limit promethazine concentration to 25 mg/mL, only about half of all respondents dilute the drug in 10 to 20 mL of saline, inject it through a running line, and advise patients to report IV site discomfort. "The authors make no claims of the accuracy of the information contained herein; and these suggested doses and/or guidelines are not a substitute for clinical judgment.
Image provided courtesy of ISMP. Consider 6.25 to 12.5 mg of promethazine as the starting IV dose, especially for elderly patients. Allergic Conditions.
Create alerts. Extravasation can also be recognized more quickly when promethazine is diluted than if the drug is given in a smaller volume. Dosage must be individualized. Caution should be exercised when administering promethazine hydrochloride injection to pediatric patients 2 years of age and older (seePromethazine hydrochloride injection can cause severe chemical irritation and damage to tissues regardless of the route of administrationDue to the risks of intravenous injection, the preferred route of administration of promethazine hydrochloride injection is deep intramuscular injection. Available for Android and iOS devices. Phenergan (Promethazine HCl) Reactions in pediatric patients. Only about a quarter limit the starting dose to 6.25 to 12.5 mg, provide alerts …
Some complications of administration can include burning, erythema, tissue necrosis, and gangrene. If you are not sure, and suppositories and may be made. Avoid concomitant administration of other drugs with respiratory depressant effects because of an association with respiratory depression, and sometimes death, in pediatric patients.Promethazine hydrochloride injection can cause severe chemical irritation and damage to tissues regardless of the route of administrationBecause of the risks of intravenous injection, the preferred route of administration of promethazine hydrochloride injection is deep intramuscular injection (see).
Promethazine Extravasation Causes Gangrene in Man’s Fingers. One practitioner questioned whether serious tissue injury occurs primarily with inadvertent arterial injections rather than IV extravasations. and untreated or inadequately treated extrapyramidal signs and symptoms (EPS). If a patient complains of pain during intended intravenous injection, stop the injection immediately; suspect inadvertent intra-arterial injection.
Because animal reproduction studies are not always predictive of human response, promethazine hydrochloride injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Adequate studies to determine the action of the drug on parturition, lactation and development of the animal neonate have not been conducted.Promethazine hydrochloride injection administered to a pregnant woman within two weeks of delivery may inhibit platelet aggregation in the newborn.Promethazine hydrochloride injection may be used alone or as an adjunct to narcotic analgesics during labor (see It is not known whether promethazine hydrochloride injection is excreted in human milk. Give the medication only through a large-bore vein (preferably via a central venous access site, but absolutely no hand or wrist veins). Check patency of the access site before administration... [See ISMP for further info ] Inject into the furthest port. After initiation of treatment, dosage should be adjusted to the smallest amount adequate to relieve symptoms. I don't give Phenergan anymore without diluting it in 50 cc's of NS. Promethazine hydrochloride injection, USP is a sterile, pyrogen-free solution for deep intramuscular or intravenous administration. Postmarketing cases of respiratory depression, including fatalities, have been reported with use of promethazine … ... [See ISMP for further info ] Remove from formulary. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. About half of all respondents agreed that IV promethazine should never be administered via hand or wrist veins, but just 10% reported following such a policy.
5-HT3 agents bind to the vagal neuron receptors, thus blocking the signal to vomit. Furthermore, there is evidence that codeine, which is combined with promethazine in some medications, is addictive. Copyright(c) 2016 First Databank, Inc.Sorry. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. Diazepam may be used to control convulsions. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when promethazine is injected.
A paradoxical-type reaction has been reported in pediatric patients receiving single doses of 75 mg to 125 mg orally, characterized by hyperexcitability and nightmares.Atropine-like signs and symptoms-dry mouth; fixed, dilated pupils; flushing; etc., as well as gastrointestinal symptoms, may occur.Treatment of overdosage is essentially symptomatic and supportive. Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology.The management of NMS should include 1) immediate discontinuation of promethazine hydrochloride, antipsychotic drugs, if any, and other drugs not essential to concurrent therapy, 2) intensive symptomatic treatment and medical monitoring, and 3) treatment of any concomitant serious medical problems for which specific treatments are available.
Do not use if there is a precipitate or any sign of incompatibility.The average adult dose is 25 mg. Nausea & Vomiting. Note that any depressant effects of promethazine hydrochloride injection are not reversed by naloxone.Avoid analeptics, which may cause convulsions. Do not use promethazine hydrochloride injection if solution has developed color or contains precipitate. Other reported reactions include hyperreflexia, hypertonia, ataxia, athetosis, and extensor-plantar reflexes (Babinski reflex).Stimulation may be evident, especially in pediatric patients and geriatric patients. Educate patients. For example, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists may be used for both prophylaxis and as a rescue antiemetic.