Promethazine
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. |
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