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Injectable promethazine in clinics and hospitals: What's the alternative?
JAAPA
January 2025
At the University of Toledo in Toledo, Ohio, Andrew Overholser is an assistant professor in the PA program and practices in the Department of Family Medicine, Megan Sizemore is an assistant professor and clinical pharmacist in the Department of Family Medicine, and Eric Czech is an assistant professor in the PA program and practices in the Department of Family Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise.
The Institute for Safe Medication Practices and the American Society of Health-System Pharmacists have advocated for removing all injectable promethazine from inpatient and outpatient settings; however, this drug is still being used despite the risk for tissue necrosis, gangrene, and possible amputation when it inadvertently is given by the subcutaneous or intra-arterial route. This article describes alternative injectable medications that can be selected based on patient comorbidities, indications, and clinician experience.
View Article and Find Full Text PDFSuper-Selective Intra-arterial Thrombolytic Therapy for Peripheral Facial Paralysis After Postauricular Hyaluronic Acid Injection for the Esthetic Correction of Lying Ears.
Aesthetic Plast Surg
August 2024
Plastic and Reconstructive Surgery Unit, Department of Burns and Plastic Surgery, Fourth Medical Center, PLA General Hospital, 51 Fucheng Rd, Beijing, 100048, China.
Background: Hyaluronic acid (HA) injection in the auricular base is one of the most popular and non-surgical cosmetic procedures for correcting lying ears and optimizing the facial profile because of its minimal invasiveness, immediate effect and safety (Li et al. in Aesthet Surg J 44: 746-75, 2024). But we have recently discovered that this treatment may lead to a new and rare complication called peripheral facial paralysis that has never been reported before.
View Article and Find Full Text PDFSubcutaneous and Intra-Arterial Nitroglycerin Administration to Facilitate Femoral Artery Access for Neuroendovascular Procedures on Infants and Toddlers.
J Vasc Interv Radiol
September 2024
Department of Interventional Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Portland, OR 97239.
Robotic Versus Open Hepatic Arterial Infusion Pump Placement for Unresectable Intrahepatic Cholangiocarcinoma.
Ann Surg Oncol
June 2024
Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Background: Hepatic arterial infusion pump (HAIP) chemotherapy is an effective treatment for patients with unresectable intrahepatic cholangiocarcinoma (iCCA). HAIP chemotherapy requires a catheter inserted in the gastroduodenal artery and a subcutaneous pump. The catheter can be placed using an open or robotic approach.
View Article and Find Full Text PDFPROMETHAZINE-INDUCED THROMBOPHLEBITIS IN A NIGERIAN MAN: A CASE REPORT.
West Afr J Med
December 2023
Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ituku- Ozalla Campus, Enugu, Nigeria.
Introduction: Promethazine is a phenothiazine derivative that possesses antihistamine, anti-dopaminergic and anticholinergic properties. It is commonly used to treat motion sickness, allergic conditions, nausea and vomiting, in addition to its use as a sedative. Promethazine has vesicant properties and is highly caustic to the intima of blood vessels and surrounding tissues.
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