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121. 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

122. RCEM guidelines for management of Acute Behavioural Disturbance

and are commonly used for the sedation of agitated psychiatric patients. Anti-psychotics offer the theoretical pharmacological benefit in the management of ABD due to their dopamine receptor antagonism, as one of the postulated causes of ABD is excess dopamine levels 10 . Traditional neuroleptics such as haloperidol have well recognised side effects such as prolongation of the QTc interval and cardiac arrhythmias. NICE does recommend the use of haloperidol with promethazine for rapid tranquilisation

2016 Royal College of Emergency Medicine

124. Use of Antipsychotics and/or Benzodiazepines as Rapid Tranquilization in In-Patients of Mental Facilities and Emergency Departments: A Review of the Clinical Effectiveness and Guidelines

of antipsychotics and benzodiazepines, with some studies suggesting they are similar, while others favouring one treatment over another. One notable exception, however, is that there appears to be relatively consistent evidence that intramuscular haloperidol is less effective and more harmful than other therapies. One guideline suggests using IM lorazepam or a combination of IM haloperidol and promethazine as rapid tranquilization for adults in in-patient psychiatric or emergency department settings, and IM

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

128. Drugs to avoid in 2015

this isoenzyme (Rev Prescrire n° 337). It is far more prudent to choose a non-sedative and non-antimuscarinic antihistamine such as loratadine or ceti- rizine. – Injectable promethazine, an antihista- mine used to treat severe urticaria, can cause thrombosis, skin necrosis and gan- grene following extravasation or inad- vertent injection into an artery (Rev Prescrire n° 327). It is more prudent to use injectable dexchlorpheniramine, which does not appear to carry these risks (1). Diabetes - Nutrition

2015 Prescrire

131. 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

132. Treatment-Related Nausea and Vomiting (PDQ®): Health Professional Version

more than one or two doses of a drug are to be given. Table 3. Prevention of Acute or Delayed CINV Drug Category Medication Dose Available Route Comment(s) Reference(s) Dopamine antagonists: phenothiazines Chlorpromazine 10–25 mg PO q4–6h PO, IM Prolongs QT interval [ , ][ ] 25–50 mg IM q3–4h Prochlorperazine 25 mg PR q12h PO, IM, IV, PR Less sedation, but increased risk of EPS [ ] 5–10 mg PO/IM/IV q6–8h Promethazine 12.5–25 mg q4–6h PO, IM, IV, PR Vesicant [ ][ ] Weak antiemetic Dopamine

2018 PDQ - NCI's Comprehensive Cancer Database

133. Nausea/vomiting in pregnancy

by the National institute for Health and Clinical Excellence. Issued in December 2008. August 2008 — minor update to text regarding the safety of promethazine in pregnancy. February to May 2008 — converted from CKS guidance to CKS topic structure. The evidence base has been reviewed in detail, and recommendations are more clearly justified and transparently linked to the supporting evidence. There are no major changes to the recommendations. October 2005 — minor technical update. Issued in November 2005 (...) and vomiting in pregnancy. The RCOG makes similar recommendations about patient support groups on the basis that women and their partners may find this helpful [ ]. Drug treatment Which drug treatments can be considered? Consider drug treatment with an anti-emetic if initial treatments such as dietary advice or rest have failed and the woman has persistent symptoms. If an anti-emetic is required in pregnancy, prescribe an antihistamine (oral cyclizine or oral promethazine), or a phenothiazine (oral

2018 NICE Clinical Knowledge Summaries

134. Palliative care - oral

(opioid) Morphine, oxycodone Antidepressants (tricyclics) Amitriptyline, clomipramine Antidepressants (selective serotonin reuptake inhibitors) Citalopram, fluoxetine Antiemetics Hyoscine hydrobromide Antiepileptics Carbamazepine, gabapentin Antihistamines (sedating) Chlorphenamine, promethazine Antimanics Lithium carbonate, lithium citrate Antiparkinsons Orphenadrine, procyclidine Antipsychotics Olanzapine Antispasmodics Oxybutynin, solifenacin Beta-blockers Atenolol, propranolol Diuretics Furosemide

2018 NICE Clinical Knowledge Summaries

135. 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)

137. The economic burden of inpatient care of depression in Poznan (Poland) and Kiel (Germany) in 2016. Full Text available with Trip Pro

by the length of hospital stay, giving the cost of hospitalization. The annual cost of inpatient care of depression in 2016 was EUR 491,067.19 ([Formula: see text]) in Poznan and EUR 2,847,991.00 [Formula: see text] in Kiel. In Poznan, hospitalization was underfunded reaching EUR 183,042.55 (37.27% of total costs in Poznan). In Poznan, the most frequently prescribed medicine was quetiapine, followed by olanzapine and venlafaxine, whereas in Kiel it was venlafaxine, followed by mirtazapine and promethazine

2018 PLoS ONE

139. ASCIA Clinical Update - Anaphylaxis

if there are no skin symptoms. It is important to note that antihistamines have no role in treating or preventing respiratory or cardiovascular symptoms of anaphylaxis. Oral non-sedating antihistamines may be given to treat itch and urticaria. Oral sedating antihistamines are not recommended as side effects (drowsiness) may be similar to signs of anaphylaxis. Injectable promethazine should not be used in anaphylaxis as it can worsen hypotension and cause muscle necrosis 21 . 4.2. Observation after anaphylaxis (...) . Biphasic anaphylaxis: Review of incidence, clinical predictors and observation recommendations. Immunol Allergy Clin North Am. 2007; 27 (20): 309-26 viii. 21. US Food and Drug administration. FDA requires boxed warning for promethazine hydrochloride injection (website). 22. Vale S, Smith J, Loh R. Safe use of adrenaline autoinjectors. Australian Prescriber. April 2012 23. PBS for health professionals. Canberra: Australian

2016 Australasian Society of Clinical Immunology and Allergy

140. 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

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