Clinical Medications Worksheets
Generic Name Trade Name Classification
promethazine Phenergan antiemetics
Peak Onset Duration Normal dosage range
unknown 3-5 min 4-12 hr 10-25mg q 4hr PRN
Rate: Administer each 25 mg slowly, over at least 1 min
Why is your patient getting this medication
Prevention of nausea/vomiting
Mechanism of action and indications
(Why med ordered)
Blocks the effects of histamine, has inhibitory
effect of the chemoreceptor trigger zone in the
medulla, resulting in antiemetic properties. Alters
the effects of dopamine in the CNS. Possesses
significant anticholinergic activity. Produces
CNS depression by indirectly decreased
stimulation of the CNS reticular system.
Interactions with other patient drugs, OTC or
herbal medicines (ask patient specifically)
Additive CNS depression with other CNS depressants,
including opioid analgesics (lortab, fentanyl) , and other
sedative/hypnotics (lorazapam)
Nursing Process- Assessment
(Pre-administration assessment)
Monitor blood pressure, pulse, and RR
frequently. Assess for level of
nausea/vomiting
Dose Route Time/frequency
25mg IVP Q 4 hrs PRN
For IV meds, compatibility with IV drips and/or
solutions
No compatibility issues with medications/fluids for this
patient
Nursing Implications (what to focus on)
Contraindications/warnings/interactions
Hypersensitivity, Geri: Appears on Beers list. Geriatric patients
are sensitive to anticholinergic effects and have increased risk for side
effects
Common side effects
confusion, disorientation, sedation
Lab value alterations caused by medicine
Blood dyscrasias may occur (monitor CBC), may cause
increased serum glucose.
Be sure to teach the patient the following about this
medication
Advise patient to change positions slowly to minimize
orthostatic hypotension
Advise patient that frequent mouth rinses, good oral hygiene,
and sugarless gum or candy may decrease dry mouth. Health
care professional should be notified if dry mouth persists >2 wk
Assessment Evaluation
Why would you hold or not give this Check after giving
med? Relief from nausea and vomiting
Hypersensitivity, no nausea/vomiting,
extrapyramidal side effects (restlessness;
dystonia--muscle spasms and twisting
motions; pseudoparkinsonism--mask-like
face, rigidity, tremors, drooling, shuffling
gait, dysphagia).
Geri:Assess for adverse anticholinergic
effects (delirium, acute confusion,
dizziness, dry mouth, blurred vision,
tachycardia)