Promethazine

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Section 8 - MEDICATION GUIDELINES

ANTIEMETICS

Promethazine (PHENERGAN) / Antiemetic

DESCRIPTION:

  • Blocks cholinergic receptors in the vomiting center, which may mediate nausea and vomiting; competes with histamine for the H1 receptor site.

ACTION:

  • Blocks the effects of the hormone serotonin at the 5-HT3 -receptor sites (located in the vagal nerve terminals) that cause vomiting.
  • Half-life 3.5 - 5.5 hr

INDICATIONS:

  • Severe, persistent vomiting.

CONTRAINDICATIONS:

  • Coma, CNS depression, seizures, known hypersensitivity to drug

PRECAUTIONS:

  • Get as complete a history as possible before administering.
  • Using with epinephrine may result in further hypotension.
  • Using with barbiturates, tranquilizers, or alcohol may further CNS depression
  • FDA MANDATED BLACK BOX WARNING: If this medication is administered incorrectly it can cause severe skin damage up to and including gangrene. This damage may lead to amputation of the affected limb.

DOSAGE:

  • Currently supplied in 25 mg/ml vial
  • Adult (>13 y/o): 12.5 mg slow IVP, or IM.
    • Dilution is not necessary when given IM
    • IV site must be checked for patency before infusing the medication – document patent flow of the IV site on the patient care report
    • MUST be diluted in a minimum of 10 ml of normal saline when given IV
    • MUST be given through an IV line actively infusing fluids
  • Pediatric: .25-1mg/kg slow IVP, or IM.
    • Dilution is required as noted above.
    • The maximum single dose to be given must not exceed 12.5 mg
BLACK BOX WARNING

The IV (perenteral) administration of PHENERGAN (PROMETHAZINE) has a RELATIVE CONTRAINDICATION in children under 2 years of age. The provider must weigh the risk vs. benefit of PHENERGAN (PROMETHAZINE) administration based on the patient's condition.