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142. 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

143. 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

145. Methadone Safety Full Text available with Trip Pro

Interactions D rug E ffects on M ethadone L evels ∗ E ffects on QT c I nterval A dditive S edative or R espiratory D epressant E ffects Antibiotics Ciprofloxacin ↑ Clarithromycin ↑ ↑ Erythromycin ↑ ↑ Itraconazole ↑ Ketoconazole ↑ Fluconazole ↑ Rifampin ↓ Telithromycin ↑ Anticonvulsants Carbamazepine ↓ Phenytoin ↓ Antihistamines Diphenhydramine ↑ Promethazine ↑ Antipsychotics Quetiapine ↑ ↑ Barbiturates Phenobarbital ↓ ↑ Benzodiazepines Alprazolam ↑ ↑ Clorazepate ↑ ↑ Diazepam ↑ ↑ Estazolam ↑ ↑ Flurazepam

2014 Publication 1228

146. Extravasation and infiltration

Calcium gluconate 10% Potassium chloride 7.45% Sodium bicarbonate 4.2% & 8.4% Sodium chloride 10% Cytotoxic agents Busulphan Actinomycin-D Daunorubicin Doxorubicin Epirubicin Idarubicin Mitomycin Paclitaxel Treosulfan Vinblastine Vincristine Vinorelbine Hyperosmolar agents Total parenteral nutrition >10% dextrose Mannitol 15% Other Radiographic contrast media Promethazine (phenergan) Diazepam Digoxin ( ) This is not an exhaustive list. Risk factors for infiltration and extravasation Risk factors

2014 Publication 1593

149. Tools for Assessing Outcomes in Studies of Chronic Cough

. 2012 ; 13 : 118 . 12. B a r t o n A , Ga y dec ki P , H o l t K , S mi t h J A . D a t a r e d uc t io n f o r co ug h stud ies using distribution of audio frequency content . Cough . 2012 ; 8 ( 1 ): 12 . 13. B h at t a c h a r y a M , Jo s h i N , Y a d a v S . T o c o mp a r e t h e e f f e c t o f dextromethorphan, promethazine and placebo on nocturnal cough in children aged 1-12 y with upper respiratory infections: a randomized controlled trial . Indian J Pediatr . 2013 ; 80 ( 11 ): 891 - 895

2015 American College of Chest Physicians

152. Management of AML in Pregnancy

treatment. According to the UK Teratology Information Service (UKTIS), the first choice antiemetic drugs are the antihistamines, cyclizine and promethazine (UKTIS ). Prochlorperazine and metoclopromide are considered second line agents because they may be associated with maternal dystonic reactions (UKTIS ). Ondansetron can be used in cases where first and second line antiemetic therapies have been unsuccessful (Einarson et al , ). Antibiotics Patients usually suffer severe neutropenia either

2015 British Committee for Standards in Haematology

153. Strategies for discontinuing benzodiazepines

are marketed for this indi- cation. The most frequent agents used include diphen- hydramine, clorpheniramine, promethazine, hydroxizine and doxilamine. 39 An abrupt withdrawal of the drug can cause rebound insomnia. 40 Definitively their numerous anticholinergic side effects, the possibility of cognitive alterations, daytime somno- lence, accumulation of those with long elimination half- lives, and uncertainty about optimal dosing for insomnia, makes their harm-benefit relationship unfavourable, especially

2015 Drug and Therapeutics Bulletin of Navarre (Spain)

154. Is the Use of Haloperidol a Safe and Effective Method of Tranquilization for Patients With Psychosis-Induced Aggression or Agitation?

: a multicenter, randomized, double-blind, placebo- controlled trial. Ann Emerg Med. 2013;61:72-81. 4. Lukens TW, Wolf SJ, Edlow JA, et al. Clinical policy: critical issues in the diagnoses and management of adult psychiatric patient in theemergencydepartment.AnnEmergMed. 2006;46:79-99. 5. Barbui C. Intramuscular haloperidol plus promethazine is more effective and safer than haloperidol alone for rapid tranquillisation of agitated mentally ill patients. Evid Based Ment Health. 2008;11:86-87. 6. Huf G (...) , Coutinho ES, Adams CE. Rapid tranquillisation in psychiatric emergency settings in Brazil: pragmatic randomised controlled trial of intramuscular haloperidol versus intramuscular haloperidol plus promethazine. BMJ. 2007;335:869. 7. Andrezina R, Josiassen RC, Marcus RN, et al. Intramuscular aripiprazole for the treatment of acute agitation in patients with schizophrenia or schizoaffective disorder: a double-blind, placebo-controlled comparison with intramuscular haloperidol. Psychopharmacology (Berl

2014 Annals of Emergency Medicine Systematic Review Snapshots

155. Management of schizophrenia

% with the most frequent adverse effects being headache, nausea and dizziness. The somnolence rate was =7%, the frequency of injection site reactions less than 5%, dystonia less than 2% and less than 5.5% of participants experienced akathisia. Aripiprazole has been associated with an increased risk of sudden death in elderly people with dementia-related psychosis and with orthostatic hypotension. 119 Systematic reviews have examined intramuscular (IM) olanzapine 120 and haloperidol plus promethazine 121 (...) for psychosis related agitation or aggression. Based on four high quality studies it was concluded that haloperidol plus promethazine was a safe and swift treatment for psychosis related agitation or aggression, whereas use of benzodiazepines alone, such as lorazepam and particularly midazolam was difficult to justify partly due to concerns over respiratory depression. Haloperidol alone led to more movement disorder adverse effects. 117 5 • Pharmacological and related approaches 1 ++ 4 4 1 ++ 1 + 1 ++22

2013 SIGN

157. The Use of Rapid Tranquilization in Aggressive Behavior. Full Text available with Trip Pro

, e.g., when the patient is intoxicated with alcohol or suffers from a pre-existing disease. Haloperidol has a relatively weak effect on aggression when given alone and can also cause side effects such as early dyskinesia and epileptic seizures. It should, therefore, no longer be used as monotherapy. On the other hand, haloperidol combined with benzodiazepines or promethazine and monotherapy with lorazepam, olanzapine, ziprasidone, or aripiprazole intramuscular are effective options

2019 Deutsches Arzteblatt international

158. Anti-inflammatory activity of herb products from Licania rigida Benth. (Abstract)

-induced paw edema models and the animals were orally treated (p.o.) with EHFLR at doses of 25, 50, 100 mg/kg, indomethacin (10 mg/kg) for carrageenan-induced paw edema and promethazine (6 mg/kg) for dextran-induced paw edema. The possible mechanisms involved in the anti-inflammatory action of the extract were evaluated by the paw edema models induced by histamine and arachidonic acid, and by the model of carrageenan-induced peritonitis, where vascular permeability and leukocyte migration

2019 Complementary Therapies In Medicine

159. Clinical management of nausea and vomiting in pregnancy and hyperemesis gravidarum across primary and secondary care: a population based study. (Abstract)

and antiemetic prescribing increased continuously during 1998-2013 (trend p<0.001). Younger age, deprivation, Black/Asian/Mixed ethnicity, multiple-pregnancy were associated with NVP/HG generally across all levels, but associations were strongest for hospital admissions. Most comorbidities had patterns of association with NVP/HG levels. Among women with NVP/HG who had no hospital admissions, 49% were prescribed antiemetics, mainly from first line treatment (21% prochlorperazine, 15% promethazine, 13

2019 BJOG

160. Severe Viperidae envenomation complicated by a state of shock, acute kidney injury, and gangrene presenting late at the emergency department: a case report. Full Text available with Trip Pro

), coagulopathy, renal impairment, and gangrene of the entire right upper limb. Emergency management consisted of fluid resuscitation, repeated boluses of adrenaline, a total of three vials of polyvalent anti-venom sera, promethazine, analgesics, corticosteroids, and administration of fresh frozen plasma. Within four hours of emergency department hospitalisation she developped signs of sepsis and persistent hypotension refractory to fluid resuscitation, suggestive of an associated septic shock. Management

2019 BMC Emergency Medicine

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