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81. Cough (acute): antimicrobial prescribing

at night) was no more effective than placebo in reducing composite symptom scores, cough frequency or sleep disturbance in children and their parents in 1 RCT of children and young people aged 2 to 18 years with acute cough due to an upper respiratory tract infection (low quality evidence). No safety data were reported. Promethazine for 3 days was no more effective than placebo in reducing a composite cough symptom scores in 1 RCT of children and young people aged 1 to 22 years with acute cough due (...) to an upper respiratory tract infection (low quality evidence). Adverse events were reported in 32% of the promethazine group and 5% of the placebo group (p value not reported; low quality evidence). Based on 4 RCTs from 1 systematic review (Smith et al. 2014) in adults, young people and children with cough related to a common cold or upper respiratory tract infection. Over-the-counter cough medicines containing the antihistamines diphenhydramine and Cough (acute): antimicrobial prescribing (NG120) © NICE

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

82. Doxylamine/pyridoxine (Xonvea) for treating nausea and vomiting of pregnancy

treatments that are currently used for nausea and vomiting of pregnancy are much less; for example, cyclizine, prochlorperazine and promethazine. However, this does not take into account factors such as therapeutic equivalence. See the resource impact assessment accompanying this evidence review for a more detailed assessment of the budget impact of this medicine. See the full evidence review for more information. ISBN: 978-1-4731-3333-4 Doxylamine/pyridoxine (Xonvea) for treating nausea and vomiting

2019 National Institute for Health and Clinical Excellence - Advice

84. Miscellaneous treatments for antipsychotic-induced tardive dyskinesia. (PubMed)

or relaxation, (RR 0.45, 95% CI 0.21 to 0.94, 1 study, n = 15), pemoline (RR 0.48, 95% CI 0.29 to 0.77, 1 RCT, n = 46), promethazine (RR 0.24, 95% CI 0.11 to 0.55, 1 RCT, n = 34), insulin (RR 0.52, 95% CI 0.29 to 0.96, 1 RCT, n = 20), branched chain amino acids (RR 0.79, 95% CI 0.63 to 1.00, 1 RCT, n = 52), and isocarboxazid (RR 0.24, 95% CI 0.08 to 0.71, 1 RCT, n = 20). There was low- to very low-certainty evidence of no difference between intervention and placebo or no treatment for the following

2018 Cochrane

85. Peripartum Analgesia and Anesthesia for the Breastfeeding Mother

medications may be needed to treat side effects of opioids. Antinausea medications are considered safe, with ondansetron and other 5HT-3 blockers, dexamethasone, and metoclopramide preferred over more sedating medications, although prochlorperazine and promethazine are likely to be safe as well 48,49 (III- IV). Stool softeners and laxatives, such as docusate, senna, and bisacadoyl, are minimally absorbed from the gastrointestinal tract and are also considered safe for breastfeeding mothers 49 (III-IV

2019 Academy of Breastfeeding Medicine

86. Hydroxyzine

pruritus were randomly divided into 3 groups. The first group was treated with Avena sativa lotion, twice a day, for as long as 2 weeks; the second group received diluted vinegar; and the third group took hydroxyzine tablets 2015 16. Chloral Hydrate, Chloral Hydrate - Promethazine and Chloral Hydrate - Hydroxyzine Efficacy in Electroencephalography Sedation. 24445981 2014 05 28 2015 09 21 2014 05 28 0973-7693 81 6 2014 Jun Indian journal of pediatrics Indian J Pediatr Chloral hydrate, chloral hydrate (...) --promethazine and chloral hydrate - hydroxyzine efficacy in electroencephalography sedation. 541-6 10.1007/s12098-013-1298-y To compare efficacy and safety of chloral hydrate (CH), chloral hydrate and promethazine (CH + P (...) ) and chloral hydrate and hydroxyzine (CH + H) in electroencephalography (EEG) sedation. In a parallel single-blinded randomized clinical trial, ninety 1-7 y-old uncooperative kids who were referred to Pediatric Neurology Clinic of Shahid Sadoughi University, Yazd, Iran from April

2018 Trip Latest and Greatest

87. Pregnant women and poor sleep: medication is rarely the right solution

and third trimesters, provided that it is in the form of low-concentration aqueous or hydroalcoholic extract. In general, it is preferable to avoid taking concentrated plant extracts repeatedly for medicinal purposes during pregnancy, due to uncertainties about their effects. Some drugs with an adverse harm-benefit balance for pregnant women or the unborn child should be ruled out. These include alimemazine and promethazine; fast-acting benzodiazepines such as flunitrazepam and triazolam; melatonin

2018 Prescrire

88. Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures

to residual prolonged drug effects may lead to airway obstruction. , , In particular, promethazine (Phenergan; Wyeth Pharmaceuticals, Philadelphia, PA) has a “black box warning” regarding fatal respiratory depression in children younger than 2 years. Although the liquid formulation of chloral hydrate is no longer commercially available, some hospital pharmacies now are compounding their own formulations. Low-dose chloral hydrate (10–25 mg/kg), in combination with other sedating medications, is used

2019 American Academy of Pediatrics

89. Doxylamine succinate and pyridoxine hydrochloride (Xonvea) for the treatment of nausea and vomiting of pregnancy in women who do not respond to conservative management

include cyclizine, prochlorperazine, promethazine and or chlorpromazine. Clinicians should use antiemetics with which they are familiar and should use drugs from different classes if the first drug is not effective. Combinations of different drugs should be used in women who do not respond to a single antiemetic. For women with persistent or severe HG, the parenteral or rectal route may be necessary and more effective than an oral regimen. Due to the risk of extrapyramidal effects, metoclopramide (...) will resolve spontaneously within 16 to 20 weeks. 17 Additional information: comparators Cyclizine, prochlorperazine, promethazine or chlorpromazine. 12 Cost of relevant comparators Medicine Dose Regimen Cost per two week course (£) Doxylamine succinate and pyridoxine hydrochloride Initially two tablets orally at bedtime, if symptoms are not controlled this can be increased to one tablet in the morning and two tablets at bedtime and then further increased to one tablet in the morning, one tablet mid

2019 Scottish Medicines Consortium

90. Acute management of anaphylaxis guidelines

of anaphylaxis. • Do not use oral sedating antihistamines as side effects (drowsiness or lethargy) may mimic some signs of anaphylaxis. • Injectable promethazine should not be used in anaphylaxis as it can worsen hypotension and cause muscle necrosis. Corticosteroids: • The benefit of corticosteroids in anaphylaxis is unproven. • It is common practice to prescribe a 2-day course of oral steroids (e.g. oral prednisolone 1 mg/kg, maximum 50 mg daily) to hopefully reduce the risk of symptom recurrence after

2019 Clinical Practice Guidelines Portal

91. Benzodiazepines for psychosis-induced aggression or agitation. (PubMed)

benzodiazepines compared with olanzapine (n = 150, 1 RCT, RR 1.84, 95% CI 1.06 to 3.18, very low quality evidence). People receiving benzodiazepines were less likely to experience extrapyramidal effects in the medium term compared to people receiving haloperidol (n = 233, 6 RCTs, RR 0.13, 95% CI 0.04 to 0.41, low quality evidence).Benzodiazepines versus combined antipsychotics/antihistaminesWhen benzodiazepine was compared with combined antipsychotics/antihistamines (haloperidol plus promethazine

Full Text available with Trip Pro

2017 Cochrane

92. Chloral hydrate as a sedating agent for neurodiagnostic procedures in children. (PubMed)

, and three of the 13 studies had high risk of bias for selective reporting. Evaluation of the efficacy of the sedative agents was also underpowered, with all the comparisons performed in single small studies.Children who received oral chloral hydrate had lower sedation failure when compared with oral promethazine (RR 0.11, 95% CI 0.01 to 0.82; 1 study, moderate-quality evidence). Children who received oral chloral hydrate had a higher risk of sedation failure after one dose compared to those who received (...) between oral chloral hydrate, oral dexmedetomidine, oral hydroxyzine hydrochloride, and oral midazolam.Children who received oral chloral hydrate had a shorter time to achieve adequate sedation when compared with those who received oral dexmedetomidine (MD -3.86, 95% CI -5.12 to -2.6; 1 study, moderate-quality evidence), oral hydroxyzine hydrochloride (MD -7.5, 95% CI -7.85 to -7.15; 1 study, moderate-quality evidence), oral promethazine (MD -12.11, 95% CI -18.48 to -5.74; 1 study, moderate-quality

2017 Cochrane

93. Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation). (PubMed)

haloperidol with lorazepam with no significant differences with regard to number of participants asleep at one hour (1 RCT, n=60, RR 1.05, 95%CI 0.76 to 1.44, very low-quality of evidence) or those requiring additional injections (1 RCT, n=66, RR 1.14, 95%CI 0.91 to 1.43, very low-quality of evidence).Haloperidol's adverse effects were not offset by addition of lorazepam (e.g. dystonia 1 RCT, n=67, RR 8.25, 95%CI 0.46 to 147.45, very low-quality of evidence).Addition of promethazine was investigated (...) haloperidol could be life-saving. Where additional drugs are available, sole use of haloperidol for extreme emergency could be considered unethical. Addition of the sedating promethazine has support from better-grade evidence from within randomised trials. Use of an alternative antipsychotic drug is only partially supported by fragmented and poor-grade evidence. Adding a benzodiazepine to haloperidol does not have strong evidence of benefit and carries risk of additional harm.After six decades of use

Full Text available with Trip Pro

2017 Cochrane

95. CRACKCast E182 – Drug Therapy in the Geriatric Patient

guideline published semi-regularly that provides clinicians with lists of medications that should be avoided in older adults. Please refer to Table 185.3 from Rosen’s 9 th Edition for a more comprehensive summary of the most common Beers List medications prescribed in the ED. Promethazine Diphenydramine Diazepam Hydroxyzine Amitriptyline [4] List 9 harmful drug interactions in the elderly Please refer to Table 185.2 from Rosen’s 9 th Edition for a more comprehensive summary of harmful drug interactions

2018 CandiEM

97. CRACKCast E161 – Antipsychotics

is imperative and may help you save lives in the future. Shownotes – Rosen’s In Perspective A brief history of antipsychotics: In 1950, promethazine was synthesized. Soon after, chlorpromazine was synthesized. These drugs brought about sedation and apathy in patients (i.e.neuroleptic effects) The term neuroleptic has since been replaced with antipsychotic, because newer agents are less sedating In 1956, clozapine was synthesized Significant extrapyramidal effects at therapeutic doses were found to be one (...) , perphenazine, promethazine, thiordazine High Potency (First Generation Antipsychotics) Droperidol, haloperidol, loxapine, pimozide, thiothixene, trifluoperazine Atypical Antipsychotics (Second Generation Antipsychotics) Aripiprazole, asenapine, clozapine, iloperidone, lutasidone, olanzapine, paliperidone, quetiapine, risperidone, ziprasidone [4] Describe 4 common extrapyramidal reactions in antipsychotic use other than NMS Dystonic Reaction Oculogyric crisis (eyes rolling back in head) Opisthotonos (severe

2018 CandiEM

98. CRACKCast E177 – Acute Complications of Pregnancy

conclusion – Uptodate. Citing PMID (dopamine antagonist) Metoclopramide, promethazine, prochloroperazine (antihistamine H1 antagonists) Dimenhydrinate, meclizine or diphenhydramine [better safety profile for mother and unborn that most other drugs] Glucocorticoids Bottom line = no drug is 100% safe; no one drug is the best; each has its own safety and side effect profile, but they are all widely used and supported 21) Describe the diagnosis and management of PE and DVT in pregnancy Both are tough

2018 CandiEM

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