Promethazine

dr.joandr.joan عضو ماسي
تم تعديل 2009/08/04 في أدوية الطوارئ Emergency drugs
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.
ý Caution the client not to drive a car or operate other machinery.