Pharm
Promethazine
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Promethazine
, Phenergan
Indications
Nausea
or
Vomiting
Motion Sickness
or
Vertigo
Other agents are preferred (e.g. Dimenhydrinate)
Mechanism
Phenothiazine Antiemetic
Contraindications
Do not use under age 2 years
Adverse Effects
Excessive sedation
Respiratory Depression
Apnea and death have occurred in children
Precautions
Long plasma half-life (observe prior to discharge)
Lowers
Seizure
threshold
Avoid use in children (absolutely contraindicated <2yo)
Dosing
Precautions: IV dosing used but not FDA labeled
Adults: 12.5 to 25 mg PO/IM/PR q4-6 hours
Children: 0.25 to 0.5 mg/kg PO/IM/PR q4-6 hours
Maximum: 25 mg per dose
Efficacy
Less effective
Antiemetic
than
Prochlorperazine
(
Compazine
) in ER patients
Ernst (2000) Ann Emerg Med 36(2): 89-94 [PubMed]
Sedation may delay Emergency Department discharge
References
Johnson (1993) Harriet Lane, Mosby, p. 521
(2002) Tarascon Pocket Pharmacopoeia, p. 67
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