Question

Hospital – Labor and Delivery – Room 32C

Ordering Physician: Ken Lewis, DO

Patient:            Mary Smith, Age 32

Order:              Promethazine 50 mg. Infuse IV over 15 minutes PRN. May repeat in 6 hours

Supplies:         Promethazine is available in 10 mL vials at a 25 mg/mL concentration

                                                                                                                      

1 point each

1. What is the brand name of promethazine?

2. What is the pharmacologic category/class of promethazine?

3. Besides IV, what are other routes can be used to administer promethazine (list all)?

4. What is the most likely reason Dr. Lewis is ordering promethazine for this patient?

5. Is the dose appropriate for this patient? Why or why not?

     

6. What IV fluid is most compatible with promethazine and should be used to make this IV?

7. For this order, how many mL of promethazine must be added to a 50 mL bag to accurately make this order?

8. What is the most appropriate syringe size to use to make this preparation?

9. What is a serious adverse effect that has a black box warning associated with IV promethazine?

10. If Ms. Smith needed cefepime HCL IV could the nurse run both cefepime and promethazine through the same Y site? Why or why not?

11. What USP 797 risk level would this product be considered?

12. What would the BUD for this product be if kept at:

Room temperature ______________

Refrigerated ______________

Frozen ___________________

Answer 1

1. The brand name of Promethazine is,

• Promacot.
• Phenergan
• Antinaus
• Prorex.

It is an anti-histamine which is mostly used in allergic and inflammatory reaction

2. It is an anti histamine.

3. The different routes of administration of Promethazine are

• Oral in the form of tablets or solutions
• Intra-venously
• Intra-Muscular
• Rectal suppository

4. Promethazine is also a sedative. It helps reduce stress and anxiety. Considering the information given in the question, it appear that the woman is question is in labor. Promethazine during labor makes the whole experience less unpleasant and minimises the need of anaesthesia.

5. Yes, the dose is appropriate for the patient as its advisable to give 25mg/ ml of promethazine such that the 25 mg is not administered in less than 1 minute when given intravenously. Here, the concentration is appropriate and evenly spaced out over 15 minutes.

6. As most solutions, Promethazine is most compatible with Saline solution.