Event Title
Medication use evaluation of intravenous promethazine
Location
Suwanee, GA
Start Date
14-5-2019 1:00 PM
End Date
14-5-2019 4:00 PM
Description
Introduction: Intravenous (IV) promethazine is FDA approved for treatment, prevention, and control of nausea and vomiting. It is a vesicant. Some complications of administration can include burning, erythema, tissue necrosis, and gangrene. Some cases require surgical intervention. The manufacturer recommends concentrations no greater than 25 mg/ml and infusing no faster than 25 mg/minute. In September 2009, the FDA required manufacturers add black box warning for the risk of IV promethazine administration causing serious tissue injury. In 2007, IV promethazine was added to ISMP List of High Alert Medications in Acute Settings, and in 2018-2019 ISMP Best practice recommends to remove all injectable promethazine from the hospital and to classify as non-formulary. ASHP issues policy position IV promethazine may used when clinically warranted, despite recognized risks.
Research Question or Hypothesis: When dosed and administered as recommended, IV promethazine has reduced risk for infusion-related adverse effects. The primary endpoint is the frequency of adverse reactions with IV promethazine.
Study Design: Retrospective chart review using descriptive statistics for results.
Methods: Subjects at Emory Saint Joseph's Hospital were randomly selected from a promethazine drug utilization report from January 1st to December 31 st of 2017. Data collected includes patient age, gender, weight, dose and indication for promethazine, date and time administered, administration site, infusion duration, additional antiemetics, antiemetic allergies, length of stay, adverse reactions, and outcome of adverse reaction.
Results: 157 patients were randomly selected for analysis from 848 patients. 987 doses were analyzed for these patients, promethazine was the second antiemetic administered for 123 Of 157 patients analyzed. One patient had an adverse drug reaction with a possible link to intravenous promethazine (<1%). The reaction was edema and erythema at the site of injection, which subsided without further incident after the site of injection was changed.
Conclusion: IV promethazine is a reasonable alternative for preventing or managing nausea and vomiting.
Embargo Period
1-28-2020
Medication use evaluation of intravenous promethazine
Suwanee, GA
Introduction: Intravenous (IV) promethazine is FDA approved for treatment, prevention, and control of nausea and vomiting. It is a vesicant. Some complications of administration can include burning, erythema, tissue necrosis, and gangrene. Some cases require surgical intervention. The manufacturer recommends concentrations no greater than 25 mg/ml and infusing no faster than 25 mg/minute. In September 2009, the FDA required manufacturers add black box warning for the risk of IV promethazine administration causing serious tissue injury. In 2007, IV promethazine was added to ISMP List of High Alert Medications in Acute Settings, and in 2018-2019 ISMP Best practice recommends to remove all injectable promethazine from the hospital and to classify as non-formulary. ASHP issues policy position IV promethazine may used when clinically warranted, despite recognized risks.
Research Question or Hypothesis: When dosed and administered as recommended, IV promethazine has reduced risk for infusion-related adverse effects. The primary endpoint is the frequency of adverse reactions with IV promethazine.
Study Design: Retrospective chart review using descriptive statistics for results.
Methods: Subjects at Emory Saint Joseph's Hospital were randomly selected from a promethazine drug utilization report from January 1st to December 31 st of 2017. Data collected includes patient age, gender, weight, dose and indication for promethazine, date and time administered, administration site, infusion duration, additional antiemetics, antiemetic allergies, length of stay, adverse reactions, and outcome of adverse reaction.
Results: 157 patients were randomly selected for analysis from 848 patients. 987 doses were analyzed for these patients, promethazine was the second antiemetic administered for 123 Of 157 patients analyzed. One patient had an adverse drug reaction with a possible link to intravenous promethazine (<1%). The reaction was edema and erythema at the site of injection, which subsided without further incident after the site of injection was changed.
Conclusion: IV promethazine is a reasonable alternative for preventing or managing nausea and vomiting.