promethazine

Warnings and precautions

Black Box Warning: Infants, neonates, children, intraarterial/SUBCUT adminis- tration, extravasation Precautions: Pregnancy, cardiac/renal/ hepatic disease, asthma, seizure disorder, prostatic hypertrophy, bladder obstruc- tion, glaucoma, COPD, GI obstruction, ileus, CNS depression, diabetes, sleep apnea, urinary retention, IV use Black Box Warning: Tissue necrosis (IV use) Black Box Warning: Check for extrava- sation: burning, pain, swelling at IV site; can cause tissue necrosis • Do not use if precipitate is present • Rapid administration may cause tran- sient decrease in B/P • After diluting each 25-50 mg/9 mL of NaCl for inj; give ≤25 mg/2 min Y-site compatibilities: Alfentanil, amifos- tine, amikacin, aminocaproic acid, amsa- crine, anidulafungin, ascorbic acid, ateno- lol, atracurium, atropine, aztreonam, benztropine, bivalirudin, bleomycin, bumetanide, buprenorphine, butorpha- nol, calcium chloride/gluconate, CARBO- platin, caspofungin, chlorproMAZINE, cimetidine, ciprofloxacin, ­cisatracurium, CISplatin, cladribine, codeine, cyanoco- balamin, cyclophosphamide, cycloSPO- RINE, cytarabine, DACTINomycin, DAPTO- mycin, dexmedetomidine, digoxin, diltiaZEM, diphenhydrAMINE, DOBUTa- mine, DOCEtaxel, DOPamine, doxacu- rium, DOXOrubicin, doxycycline, enala- prilat, ePHEDrine, EPINEPHrine, epirubicin, epoetin, eptifibatide, erythro- mycin, esmolol, etoposide, famotidine, fenoldopam, fentaNYL, filgrastim, flucon- azole, fludarabine, gemcitabine, gentami- cin, glycopyrrolate, granisetron, HYDRO- morphone, hydrOXYzine, IDArubicin, ifosfamide, insulin (regular), irinotecan, isoproterenol, labetalol, levoFLOXacin, lidocaine, linezolid, LORazepam, magne- sium sulfate, mannitol, mechlorethamine, melphalan, meperidine, metaraminol, methoxamine, methyldopate, metoclo- pramide, metoprolol, metroNIDAZOLE, miconazole, midazolam, milrinone, mito- XANTRONE, morphine, mycophenolate, nalbuphine, naloxone, netilmicin, nitro- glycerin, norepinephrine, octreotide, ondansetron, oxaliplatin, oxytocin, PACLi- taxel, palonosetron, pamidronate, pan- curonium, PEMEtrexed, pentamidine, pentazocine, phenylephrine, polymyxin B, procainamide, prochlorperazine, pro- pranolol, protamine, pyridoxine, quiNI- Dine, quinupristin-dalfopristin, raNITI- dine, remifentanil, Ringer’s, ritodrine, riTUXimab, rocuronium, sargramostim, sodium acetate, succinylcholine, SUFent- anil, tacrolimus, teniposide, theophylline, thiamine, thiotepa, tigecycline, tirofiban, TNA, tobramycin, tolazoline, trastuzumab, trimetaphan, vancomycin, vasopressin, vecuronium, verapamil, vinCRIStine, vinorelbine, voriconazole Black Box Warning: Child:  not to be used in children <2 yr, fatal respiratory depression may occur; use cautiously in children >2 yr, seizures, paradoxical CNS stimulation may occur • Antiemetic/motion sickness: nausea, vomiting before, after dose • I&O ratio; be alert for urinary reten- tion, frequency, dysuria; product should be discontinued • Respiratory depression/sedation: de- gree of sedation, respiratory risk, CNS depressants may cause increased sedation • EPS: pseudoparkinsonism, dystonia, akathisia, may be worse in geriatric pa- tients • Anticholinergic effects: dry mouth, confusion, urinary retention, more com- mon in geriatric patients • CBC with differential, LFTs during long- term therapy; blood dyscrasias, jaundice may occur • Respiratory status: rate, rhythm, in- crease in bronchial secretions, wheezing, chest tightness • Cardiac status: palpitations, increased pulse, hypo/hypertension, B/P in those receiving IV doses • Neuroleptic malignant syndrome: fever, confusion, diaphoresis, rigid muscles, elevated CPK, encephalopa- thy; discontinue product, notify pre- scriber • Hard candy, gum, frequent rinsing of mouth for dryness

Source pages 1094, 1095, 1096