RE: phenergan

[Lynn Hadaway]

Title: RE: phenergan

It is a good drug, but it is dangerous to give IV. The IV route requires as much attention to careful administration as any antineoplastic drug. Promethazine is a vesicant and the nurse must determine absolute vein and catheter patency before it is given. Also drug literature now recommends that it be given only through an infusing IV fluid.

Here is a link to a newspaper article about a $7.4 million jury award from a promethazine infiltration case.

http://www.timesargus.com/apps/pbcs.dll/article?AID=/20040316/NEWS/403160343&SearchID=732215378965

More than half my lawsuits that I have reviewed over the past 6 years have involved this drug. Lynn

At 2:16 PM -0600 3/1/06, Feckers, Charlotte wrote:

To the group:  I read this e-mail this am and sure enough we had a Doc order phenergan 12.5 Iv I spoke up and said it had just been on the link how bad it was.  He and the pharmacist both told me it was fine to give as long as you make sure you have a good vein.... Not a central line but a good vein.  The pharmacist told me if it was as bad as I was saying we would have had it pulled from the shelves.  Anyone out there this afternoon with some good come backs I don't have a lot of time this afternoon to research articles.

Thanks in advance Charlotte RNCRNI

-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Lynn Hadaway
Sent: Wednesday, March 01, 2006 10:54 AM
To: Kilbourne, Susan; [EMAIL PROTECTED]; [EMAIL PROTECTED]
Subject: Re: phenergan

While there are numerous lawsuits involving promethazine injuries, there is not much that has ever been published. The following are the only ones that I know of:

Extravasation of I.V. promethazine      M. Malesker, P. Malone, C. Cingle, R. Cochran   American journal of health-System pharmacy      unusual drug experiences, FDA, promethazine injection, intra-arterial injection, extravasation, dominal hysterectomy    05-14-01        Vol. 56, September 1, 1999      1742-1743       2049    Case Report

Accidental intra-arterial injection of promethazine HCI during general anesthesia: report of a case     H. Mostafavi, M. Samimi Anesthesiology  intra-arterial injection, promethazine hydrochloride (Phenergan), anesthesia    10-30-02        Vol. 35, No. 6, December 1971   645-646 2836    Case Report

Promethazine adverse events after implementation of a medication shortage interchange.  H. Sheth, M. Verrico, S. Skedar, A. Towers      Ann Pharmacother        promethazine, adverse events,   11-11-5 Volume 39, Number 2, February 2005      255-261 5265    Abstract

Adverse reactions related to phenergan  C. Blankenship  Gastroenterology Nursing        Phenergan, arterial misplacement, PICC, pediatrics, seizure activity    11-04-04        Volume 24, Number 3     149-150 3985    Review

At 5:23 PM -0800 2/28/06, Kilbourne, Susan wrote:

We are finally having a team meeting at our hospital to discuss the use of IV phenergan through peripheral lines after having two problems in the past year. The problem is convincing the MDs. Can anyone point me to some specific literature to support of dangers of infiltrated phenergan?

Thanks in advance,
Sue Kilbourne CRNI, OCN

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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861

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Lynn Hadaway, M.Ed., RNC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
http://www.hadawayassociates.com
office 770-358-7861