Promethazine
Trade names: phenergan, prothiazine
Class: Antihistamines Pregnancy: (Category C)
Action:
§ It may cause sever drowsiness.
§ It also provides antiemetic effect
§ (it affects the chemo receptor trigger zone ).
§ It also has a sedative action, effective in vertigo
Vestibular apparatus
Uses:
ý
Motion sickness.
ý
Nausea
& vomiting due to anesthesia.
Dose:
by mouth, 25 mg at
night increased to 25 mg twice daily if necessary or 10–20 mg 2–3 times daily;
CHILD under 2 years not recommended, 2–5 years 5–15 mg daily in 1–2 divided
doses, 5–10 years 10–25 mg daily in 1–2 divided doses, Premedication, CHILD
under 2 years not recommended, 2–5 years 15–20 mg, 5–10 years 20–25 mg
By deep
intramuscular injection, 25–50 mg; max. 100 mg; CHILD 5–10 years 6.25– 12.5 mg,
Premedication, 25–50 mg 1 hour before operation; CHILD 5–10 years, 6.25–
12.5 mg, By slow intravenous injection
in emergencies, 25–50 mg as a solution containing 2.5 mg/mL in water for
injections; max. 100 mg Contraindications:
ý
Hypersensitivity. ý Pregnancy.
ý
Glaucoma
ý
Prostatic hypertrophy
ý
CNS depression
(phenothiazine type). ý Bone marrow depression
ý
Comatose patients.
Side effects:
• Sedation - deep sleep - Dizziness - Headache - muscle weakness - disturbed coordination -
epigastric distress - dry mouth - nausea - vomiting - urinary frequency, anemia
( pancytopnea) .
•
Paradoxical excitation
(especially in children & elderly)
Restlessness, irritability, insomnia
, hysteria, tremors euphoria, nervousness, hallucinations , disorientation
& convulsion.
• Usually caused by overdose (acute toxicity).
Nursing
considerations:
ý Inject I.M. preparations deep into muscles.
ý Oral preparations may cause gastric irritation, so give drug
with meals.
ý Note if the client has any medical history of ulcer, glaucoma
& if the client is pregnant.
ý Obtain a baseline B.P. , Pulse & respiration .
ý Note signs of CNS depression (signs of overdose so induce vomiting).
ý If
in hospital, use side rails (safety measures).
ý Advice client to report signs of side effects immediately.
ý Instruct client to avoid undue exposure to sun.
ý If the drug is being used for motion sickness, it should be
taken 30 minutes before transporting.
Caution the client not to drive a car or operate other machinery
