B.

Pharmacologic Management

Adverse
Drug Name Mechanism of Action Indication Contraindications Nursing Responsibilities
Reaction
Generic Selectively blocks the H1 General Concentrations CNS: Dizziness, Before
Name receptors, diminishing the Indications - Hypersensitivity to drowsiness, poor - Observe 15 rights in drug
Promethazi effects of histamine on cells - Prevention antihistamines or coordination, administration.
ne HCl of the upper respiratory tract and treatment phenothiazines confusion, - Assess for hypersensitivity
and eyes and decreasing of nausea and - Comatose patients restlessness, and other contraindications.
Trade the sneezing, mucus vomiting - Severe CNS excitation, - Reduce dosage for patients
Name production, itching and associated depression seizures, tremors, with hepatic impairment.
Phenergan tearing that accompany with - Bone marrow headache, blurred - Reduce dosage of
allergic reactions in labyrinthitis depression vision, diplopia, barbiturates given
sensitized people exposed - Prevention of - Vomiting of unknown vertigo, tinnitus concurrently with
to antigens; blocks motion cause CV: Hypotension, promethazine by at least a
cholinergic receptors in the sickness - Concomitant therapy palpitations, half.
vomiting centre that are - Short-term with MAOI’s bradycardia, - Arrange for dosage
believed to mediate the management - Lactation tachycardia, reduction of opioid analgesics
nausea and vomiting of insomnia extrasystoles given concomitantly by one-
caused by gastric irritation, - Symptomatic Precaution Dermatologic: fourth to one-half.
by input from the vestibular relief of - Lower respiratory Urticaria, rash,
apparatus, and by input perennial and tract disorders photosensitivity, During
from the chemoreceptor seasonal - Glaucoma chills - Do not give tablets or rectal
trigger zone; depresses the allergic rhinitis, - Prosthatic GI: Epigastric suppositories to children
RAS, including the parts of allergic hypertrophy distress, nausea, younger than 2 yr.
the brain involved with conjunctivitis, - CV disease, vomiting, - Give IM injections deep into
wakefulness. uncomplicated hypertension diarrhea, muscle.
urticaria and - Breast cancer constipation - Do not administer
Pharmacokinetics angioedema - Thyrotoxicosis GU: Urinary subcutaneously, tissue
- Amelioration - Children frequency, necrosis may occur.
A: Well absorbed (Oral, IM); of allergic - Child with history of dysuria, urinary - Do not administer
peak plasma concentrations reactions to sleep apnea retention, intrarterially; arteriospasm and
after 2-3 hr. blood or - A family history of decreased libido, gangrene of the limb may
D: Widely distributed: Brain, plasma SIDS impotence result.
crosses the placenta, enters - - Reye’s syndrome Hematologic: - Instruct to take drug exactly
breast milk. Protein-binding: Dermatographi - Elderly Hemolytic as prescribed.
76-93%. sm, adjunctive - Pregnancy anemia,
M: Extensive hepatic 1st- therapy in hypoplastic After
pass metabolism; converted anaphylactic Drug interaction anemia, - Instruct to avoid alcohol.
to promethazine sulfoxide, reactions Drug to drug thrombocytopenia - Instruct to avoid driving or
N-desmethylpromethazine. - Preoperative, - Additive , leukopenia, engaging in other dangerous
E: Via urine and bile (as postoperative, anticholinergic effects agranulocytosis, activities of dizziness,
metabolites) or obstetric with anticholinergic pancytopenia drowsiness or vision changes
sedation drugs Local: Thickening occur.
Drug Half Life - Adjunct to - Increased frequency of bronchial - Educate about avoiding
9-16 hr analgesics to and severity of secretions, chest prolonged exposure to the
control neuromuscular tightness, dry sun, or using of sunscreen or
postoperative excitation and mouth, nose and covering garments.
pain hypotension with throat; respiratory - Maintain fluid intake, use
- Adjunctive IV methohexital, depression, precautions against
therapy with thiamylal, suppression of heatstroke in hot weather.
reduced Phenobarbital cough reflex, - Report sore throat, fever,
amounts of anesthetic, thiopental potential of unusual bleeding or bruising,
meperidine or - Enhanced CNS aspiration rash, fever, weakness,
other opioid depression with Other: Tingling, tremors, impaired vision, dark
analgesics in alcohol heaviness and urine, pale stools, yellowing of
special wetness of hands the skin or eyes.
surgical Drug to food
conditions - none reported