Promethazine Overview and Mechanisms

Promethazine Overview

• Generic Name: Promethazine
• Pharmacological Class: Phenothiazines
• Therapeutic Class: Antiemetic, antihistamine, sedative, hypnotic

Mechanism of Action

• Blocks histamine effects, providing relief in allergic reactions
• Inhibits the chemoreceptor trigger zone in the medulla, reducing nausea and vomiting
• Alters dopamine effects in the central nervous system (CNS)
• Exhibits significant anticholinergic activity
• Causes CNS depression by decreasing stimulation of the reticular system

Therapeutic Effects

• Alleviates symptoms from excess histamine and allergic reactions
• Diminishes nausea and vomiting
• Induces sedation

Indications for Use

• Treats various allergic conditions and motion sickness
• Provides preoperative sedation
• Prevents and treats nausea and vomiting
• Serves as an adjunct in anesthesia and analgesia

Routes of Administration

• Administered orally (PO), intramuscularly (IM), intravenously (IV), or rectally

Toxicity and Side Effects

• Common Side Effects: Confusion, disorientation, sedation
• Life-Threatening Risks: Neuroleptic malignant syndrome

Safety Classifications

• Pregnancy Category: C
• High Alert Medication: High risk for significant patient harm if misused

Patient Education

• May cause drowsiness; exercise caution
• Photosensitivity may occur
• Advise patients to rise slowly from sitting or standing positions
• Recommend frequent mouth rinsing and maintaining good oral hygiene
• Suggest using sugarless gum or candy
• Avoid alcohol consumption
• Notify healthcare team of sore throat, jaundice, fever, or uncontrolled movements

Nursing Considerations

• Ongoing patient assessment required