Medication 7-702 - Phenergan (Promethazine)

Polk, Hickory, Cedar, & St Clair EMS Protocols

Scope of Practice:

• Registered Nurse
• Paramedic

Route(s):

• IM/SQ, IO, IV,

Pharmacodynamics (class and mechanism of action):

• Anti-emetic. (Decreases Nausea and Vomiting by antagonizing H1 receptors.)

Pharmacokinetics:

• Half-life: 16-19 hours.
• Onset time:
• IM: 20 minutes.
• IV: 3-5 minutes.
• Peak action time: Unknown.
• Duration of action: Less than 12 hours.

• Peak	1	2	3	4	5	6	7	hours
  Duration	1	2	3	4	5	6	7	hours

Dosing:

• Refer to specific protocol(s) below for dose(s).

Indications:

• Protocol 2-990 - Vomiting.

Contraindications:

• ALOC.
• Jaundice.

Pregnancy Risk Factor:

• Category C
• Risk not ruled out: Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks. FDA requires a relatively large amount of high-quality data on a pharmaceutical for it to be defined as Pregnancy Category A. As a result of this, many drugs that would be considered Pregnancy Category A in other countries are allocated to Category C by the FDA.

Potential Incompatibilities:

• Medication 7-270 - Heparin.
• Medication 7-390 - Morphine.

Precautions and Adverse Effects:

• Use caution with Seizure Disorder.
• May prolong QT interval. 12-lead is indicated after administration.
• May cause Excitation.
• Possible Extra-Pyramidal Symptoms (EPS) / dystonic reactions:
• EPS is a movement disorder such as the inability to move or restlessness.
• Treat with Medication 7-090 - Benadryl.

Antidote:

• None.

Controlled Substance Information:

• Not a scheduled drug
• The DEA and FDA have not identified this drug with a schedule classification.
• DEA number: NA.
• Narcotic: No.
• Street names: NA.

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Polk, Hickory, Cedar, & St Clair County EMS Protocols by Theron Becker is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.