Promethazine for allergic reaction?

[Shishkabob]

So I was bored and checking through AMR's protocols, looking over the paramedic stuff. I get down to the drug section and look at Phenergen.


Now, I already knew it was an antiemetic, but I was surprised to read that it was also an antihistamine, and don't ever remember reading that anywhere.


So, has anyone used phenergen instead of diphenhydramine for it's antihistamine properties in their protocols? Or is it like Epi, where it's there, but not enough to even consider using it for that over benadryl, and stick with benadryl for the antihistamine/sedation effects?

Perhaps to those with a sensitivity to benadryl?

 

[akflightmedic]

Actually I have posted on this before, it has been a while and I did not bother to search to find the link for you.

However, if you go to the manufacturer website or read the paper insert in the promethazine box, you will see it was designed for allergic reactions initially.

In fact, many of my Euro and Australian counterparts looked at me like I was absolutely crazy when I suggested it for an anti emetic. They had never heard of it being used as such...LOL.

We both were shocked the other was using it as a primary drug for different reasons, guess it all depends on what part of the world in which you stand.

Cheers Mate!

 

[MrBrown]

Promethazine is a friggin brilliant anti-emetic I love the stuff to bits

Oh wow man does it get you smashed really good too!

We use it a BLS level PO and at Intermediary level IM/IV for allergic reactions but not anaphylaxis for that we use adrenaline and hyrdocortisone

 

[Melclin]

I seem to have a mild allergy to something here in this house/neighbourhood. Have trouble getting to sleep for the redness and itchiness.

Take a couple of phenergen, no more iches... and I'm out like a light.

Its used primarily here as an anti-histamine. I had never heard of its use as an anti-emetic until I came on this board. Good to know though. I chucked a couple back once when I had a crook gut a while back. Worked a treat.

 

[wvditchdoc]

Phenergan is classed strictly as a Antihistamine, it is not classed as an Antiemetic. Just one of those gee whiz nifty things it can be used for.

Promethazine (Phenergan)

Class: Antihistamine (h1 antagonist).

Actions: Mild anticholinergic activity, antiemetic, potentiates actions of analgesics.

Indications: Nausea and vomiting, motion sickness, to potentiate the effects of analgesics, sedation.

Contraindications: Comatose states, patients who have received a large amount of depressants (including alcohol).

Precautions: Avoid accidental intra-arterial injection.

Side Effects: May impair mental and physical ability, drowsiness.

Dosage: 12.5 - 25 mg.

Routes: IV/IM/PO

Pediatric Dosage: 0.5 mg/kg.

 

[Aidey]

It was also used as an anti-psychotic for a while, but it didn't work very well.

 

[cm4short]

I used it in the clinical setting on a patient who was allergic to benadryl.

 

[redcrossemt]

I used it in the clinical setting on a patient who was allergic to benadryl.

Is it possible for someone to be "allergic" to diphenhydramine or another anti-histamine?

 

[MrBrown]

Is it possible for someone to be "allergic" to diphenhydramine or another anti-histamine?

Maybe not the bendaryl itself but they could be allergic to the dye, flavour etc or a compound it is bound to

 

[8jimi8]

funny you were noticing this. I noticed the same thing. My father in law was asking me the difference between compazine and phenergan last night and when I was looking them up I noticed that a therapeutic use of phenergan was as an anti-histamine.

I kinda figured it was a mild effect, given that I've never heard of it being used that way.

I'd be interested in knowing how it stands up against diphenhydramine for this effect.

 

[Melclin]

Also has some local anesthetic properties, a fact to which I can testify is quite true. All in all its a pretty great drug.

 

[emtbill]

I always wondered why promethazine is given to potentiate narcotics. Is it because it is a prophylactic for nausea and vomiting, which could be detrimental to the patient, or does it actually promote binding of the narcotic to opiod receptors or something?

 

[mycrofft]

Prometh "potentiates analgesics"

Also, can potentiate seizures. We used to give it as a preop med sometimes along with Valium when I was in nursing school at Pteranodon U.

You can have odd reactions to Benadryl, especially parenteral. One of my superiors at a job long ago had a reaction to ampicillin, came to work for tx, got IV Benadryl and started hallucinating and screaming.

 

[eveningsky339]

Also, can potentiate seizures. We used to give it as a preop med sometimes along with Valium when I was in nursing school at Pteranodon U.

You can have odd reactions to Benadryl, especially parenteral. One of my superiors at a job long ago had a reaction to ampicillin, came to work for tx, got IV Benadryl and started hallucinating and screaming.

Sounds like a typical Monday to me.

 

[chadwick]

I hate to say it this way but Phenergan makes the analgesic and euphoric effect more potent. You get more bang out of your narcotic effects.

 

[Shishkabob]

I hate to say it this way but Phenergan makes the analgesic and euphoric effect more potent. You get more bang out of your narcotic effects.

Already known that it has potentiating effects. ^_^

 

[chadwick]

Sorry, that was meant as a direct reply to EMTBill.

 

[gamma6]

Is it possible for someone to be "allergic" to diphenhydramine or another anti-histamine?

i would have to say yes because some people are allergic to some odd stuff...hell i had this pt tell me she was allergic to epi..i was like wtf...

 

[redcrossemt]

i would have to say yes because some people are allergic to some odd stuff...hell i had this pt tell me she was allergic to epi..i was like wtf...

You can't be allergic to epinephrine... It could cause side effects that the patient doesn't like, but it doesn't mean they are allergic to it. Also, as mentioned previously, they could be allergic to a formulation of it (perhaps a nasal spray or inhaler with other ingredients).

 

[Markhk]

Also, as mentioned previously, they could be allergic to a formulation of it (perhaps a nasal spray or inhaler with other ingredients).

Yeah, the preservative for epinephrine are sulfites (in particular, sodium metabisulfite). People with sulfite allergies can still use the Epi-pen though; the benefits of epi outweigh that of the sulfite allergy risk.

Back to Phenergan...remember that IV injection can cause severe tissue damage...most hospitals prefer now to give it deep IM.

http://www.youtube.com/watch?v=OpYfVkygS1Q