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101. For Adults With Nausea and Vomiting in the Emergency Department, What Medications Provide Rapid Relief?

Difference in 30-Minute VAS (95% CI) Metoclopramide 3 (301) –5.3 (–11.3 to 0.8) Ondansetron 2 (250) –4.3 (–11.2 to 2.6) Prochlorperazine 1 (50) –1.8 (–14.4 to 10.8) Promethazine 1 (82) –8.5 (–19.8 to 2.9) Droperidol 1 (48) –15.8 (–27.0 to –4.6) VAS, 100-Point visual analog scale for nausea; CI, con?dence interval. METHODS DATA SOURCES The authors of the review searched the Cochrane Central Register of Controlled Trials (2014, issue 8), MEDLINE (January 1966 to August 2014), EMBASE (January 1980 to August (...) it virtually un- availableintheUnitedStates. Phenothiazines have been used for decades as antiemetics, yet despite their widespread use, there are several safety con- cerns. Administration of prochlor- perazine or promethazine by intravenous push has the potential to cause limb-threatening tissue necrosis. 4 It is therefore recom- mended that these medications be administered intramuscularly or as alow-doseinfusion,whichmaybe less desirable in ED settings. In addition, phenothiazines, as well

2016 Annals of Emergency Medicine Systematic Review Snapshots

102. The Management of Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum

review 5 and other systematic reviews and meta-analyses 34–36 and birth registry data 36 have reported on the safety and efficacy of many antiemetics for use in NVP and HG, with no increased risk of teratogenesis or other adverse pregnancy outcomes. These drugs include: antihistamines (histamine H1 receptor antagonists) such as promethazine, cyclizine, cinnarizine, doxylamine 37 and dimenhydrinate; phenothiazines including prochlorperazine, chlorpromazine and perphenazine; and dopamine antagonists (...) pyridoxine alone. Corticosteroids Corticosteroids should be reserved for cases where standard therapies have failed. Corticosteroids have resulted in dramatic and rapid improvement in case series of women with refractory HG. 50 The results of randomised studies are conflicting 51 and the largest study failed to show improvement in the primary outcome of rehospitalisation (however, both groups also received metoclopramide and promethazine). 52,53 Case selection and route and dose of corticosteroid

2016 Royal College of Obstetricians and Gynaecologists

103. CRACKCast E029 – Nausea and Vomiting

Prochlorperazine, haloperidol, promethazine s/e: dystonic reactions (4%), sedation, restlessness (16%) Treated: with diphenhydramine or benztropine Metoclopramide (prokinetic agent – increased gastric emptying) Has mild anticholinergic and antiserotonin effects Useful in GERD, gastroparesis s/e: tardive dyskinesia, drowsiness, diarrhea, Serotonin antagonists Ondansetron – s/e headaches and constipation/diarrhea Benzodiazepines: No literature to support their routine use for non-specific N/V in the ED Non-pharm

2017 CandiEM

106. Constipation in older adults: Stepwise approach to keep things moving

) Anticholinergic drugs: antipsychotic drugs, benztropine, oxybutynin Anti-Parkinson drugs: amantadine, bromocriptine, pramipexole Anticonvulsant drugs: gabapentin, phenytoin, pregabalin Antidepressant drugs: tricyclic antidepressants, paroxetine Antidiarrheal drugs: diphenoxylate, loperamide Antiemetic drugs: dimenhydrinate, ondansetron, prochlorperazine, promethazine, scopolamine Antihistamine drugs: diphenhydramine, hydroxyzine Antihypertensive drugs: α-adrenergic agonists (eg, clonidine), β-blockers

2016 RxFiles

107. Atopic Dermatitis - Guidelines for Prescribing Topical Corticosteroids (Full text)

which are known to cause drug-induced skin lesions most commonly. Antibiotics chloramphenicol, clioquinol, gentamicin, neomycin, penicillin, streptomycin, sulfonamides Antihistamines promethazine Beta-blockers metoprolol,propranolol,timolol Calcium Channel Blockers amlodipine, diltiazem, felodipine,nifedipine, verapamil Diuretics thiazide diuretics Sulfonylureas tolbutamide, chlorpropamide Antipsychotics phenothiazines, e.g., chlorpromazine, fluphenazine, perphenazine, prochlorperazine

2017 medSask PubMed

108. Violence and aggression: short-term management in mental health, health and community settings

, or no electrocardiogram has been carried out, avoid intramuscular haloperidol combined with intramuscular promethazine and use intramuscular lorazepam instead. P Post-incident debrief and re ost-incident debrief and review view F Formal e ormal external post-incident r xternal post-incident review eview The service user experience monitoring unit or equivalent service user group should undertake a formal external post-incident review as soon as possible and no later than 72 hours after the incident. The unit or group

2015 National Institute for Health and Clinical Excellence - Clinical Guidelines

109. Delirium in Adult Cancer Patients: ESMO Clinical Practice Guidelines

anticholinergic activity, e.g. tricyclic antidepressants, diphenhydramine, promethazine, trihexyphenidyl, hyoscine butylbromide Other psychoactive: antipsychotics, antidepressants, levodopa, lithium Anti-infectives: cipro?oxacin, acyclovir, ganciclovir Histamine H2 blockers Omeprazole Immunomodulators: interferon, interleukins, ciclosporin Medication polypharmacy Otherstatusorpredisposingcomorbidities[5,39] Age> 70 years Pre-existing cognitive impairment, e.g. dementia History of delirium Hearing impairment

2018 European Society for Medical Oncology

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

after discharge attributable to residual prolonged drug effects may lead to airway obstruction. 62,63,242 In parti- cular, promethazine (Phenergan; Wyeth Pharmaceuticals, Philadelphia, Pa.) has a “black box warning” regarding fatal respiratory depression in children younger than 2 years. 243 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

2016 American Academy of Pediatric Dentistry

112. No clear “best” treatment of mild or severe sickness in pregnancy

recurrence reduces risk of moderate/severe NVP compared with taking Diclectin once symptoms begin. Promethazine is as, and ondansetron is more, effective than metoclopramide for severe NVP/HG. I.v. fluids help correct dehydration and improve symptoms. Dextrose saline may be more effective at reducing nausea than normal saline. Transdermal clonidine patches may be effective for severe HG. Enteral feeding is effective but extreme method treatment for very severe symptoms. Day case management for moderate

2018 NIHR Dissemination Centre

113. Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs

, promethazine, acetaminophen, trace amounts of cocaine W-18 Seized in Edmonton (seizure, Dec. 2015; confirmed by testing, April, 2016) seized-in-edmonton/ Edmonton, Alberta, Canada April, 201 6 4 kg of white powder W-18 ‡ Norco tablets, when manufactured and sold legitimately, contain acetaminophen and hydrocodone (325 mg/10 mg). They are not sold commercially in Canada. CCENDU Bulletin: Novel Synthetic Opioids in Counterfeit Pharmaceuticals and Other Illicit Street Drugs Canadian

2016 Canadian Centre on Substance Abuse

115. Nonsurgical Management of Osteoarthritis of the Knee

with caution in patients with a history or risk of seizures or those who are taking drugs that reduce the seizure threshold, such as antidepressants, anorectics, selective serotonin reuptake inhibitors (SSRIs), SNRIs, tricyclic antidepressants, tricyclic compounds (such as cyclobenzaprine, promethazine), other opioids, monoamine oxidase inhibitors (MAOIs), and neuroleptics. Careful attention should be given to recommended dosage adjustments and maximal dosage limits in at-risk populations (e.g

2016 National Guideline Clearinghouse (partial archive)

117. 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

2016 Clinical Practice Guidelines Portal

118. Drugs for the treatment of nausea and vomiting in adults in the emergency department setting. (Full text)

) -11.33 to 0.80), ondansetron (two trials, 250 participants; MD -4.32, 95% CI -11.20 to 2.56), prochlorperazine (one trial, 50 participants; MD -1.80, 95% CI -14.40 to 10.80), promethazine (one trial, 82 participants; MD -8.47, 95% CI -19.79 to 2.85) and droperidol (one trial, 48 participants; MD -15.8, 95% CI -26.98 to -4.62). The only statistically significant change in baseline VAS to 30 minutes was for droperidol, in a single trial of 48 participants. No other drug was statistically significantly

2015 Cochrane PubMed

119. Adhesion prevention agents for gynaecological surgery: an overview of Cochrane reviews. (Full text)

) and pharmacological agents (gonadotrophin-releasing hormone agonist, reteplase plasminogen activator, N,O-carboxymethyl chitosan, steroid agents, intraperitoneal noxytioline, intraperitoneal heparin, systemic promethazine) with control or each other. Both reviews met all of the criteria of the AMSTAR assessment.The reviews included as outcomes both the primary outcomes of this overview (pelvic pain, pregnancy, live birth rate and quality of life (QoL)) and our secondary outcomes (adverse effects, presence

2015 Cochrane PubMed

120. Preventing Serious Tissue Injury with Intravenous Promethazine (Phenergan) (Full text)

Preventing Serious Tissue Injury with Intravenous Promethazine (Phenergan) 19561855 2013 07 04 2009 06 29 1052-1372 34 4 2009 Apr P & T : a peer-reviewed journal for formulary management P T Preventing serious tissue injury with intravenous promethazine (phenergan). 175-6 Grissinger Matthew M Mr. Grissinger is Director of Error Reporting Programs at the Institute for Safe Medication Practices in Horsham, PA ( ). eng Journal Article United States P T 9015516 1052-1372 2009 6 30 9 0

2009 Pharmacy and Therapeutics PubMed

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