IV Phenergan

shannonRN, BSN, RN · Sep 9, 2002

never seen resp. depression d/t phenergan. we use it quite frequently mostly in combo with a narcotic. i have tried to teach everyone the importance of diluting it and giving it slowly, but we all know how much some coworkers like to listen to one another.... :rolleyes:

zofran and tigan are our main nausea meds. we haven't had compazine in quite a while...

Nurse Ratched, RN · Sep 9, 2002

Originally posted by shannonRN
i have tried to teach everyone the importance of diluting it and giving it slowly, but we all know how much some coworkers like to listen to one another....

Plus it burns like hell! I used to get a perfectly lovely saline lock started only to have the person after me push that phenergan too fast and fry the site.

deespoohbear · Sep 9, 2002

Those of you who responded that you use Zofran, is that for post-op nausea too? We have a pharmacist at our hospital that says Zofran isn't for post-op use so now we use Anzemet. (Which I personally think is a joke). If any of you are using Zofran post-op can you get me references for its use? I would love to see us be able to use Zofran again.

shannonRN, BSN, RN · Sep 9, 2002

yes, we use zofran for post op nausea, but last night i was a wee bit tired and forgot to mention that we are seeing a lot of reglan ivp for post op nausea now. i work tonight, i'll ask our pharmacist and talk to my guy who is going to be a pharm d and get back to you about zofran...

eltrip · Sep 9, 2002

I haven't seen respiratory depression with phenergan, but I have seen echolalia with this medication. The patient was post-op for liver transplantation. The patient in the next room (same procedure) commented on having had the same thing happen a year or two prior...could it be related to impaired metabolism? Hmmm, I wonder?

deespoohbear · Sep 9, 2002

shannon-thanks. I would appreciate any information. The pharmacist I am talking about is also a Pharm D who is more interested in saving money than using what works. Almost all the nurses on our floor agree the Anzemet is useless. Even the surgery manager thinks the anzemet is a joke. If I have to choose from Anzemet or Phenergan, I will take the Phenergan. Just dilute the daylights out of the stuff before you give it.

shannonRN, BSN, RN · Sep 11, 2002

zofran is supposed to work best preventing postop nausea not treating it... so i guess i this really doesn't help your arguement. found this website, maybe it can be more helpful.

http://www.nursespdr.com/members/database/ndrhtml/ondansetronhydrochloride.html

labornurse · Sep 11, 2002

We have standing orders in L/D for demerol and phenergan IV during intrapartum. I really don't like it much because I have had a couple of pts who went balistic in labor. Wasn't fun.

Dazedgiggle · Sep 11, 2002

We used to use phenergan automatically in place of compazine because of the shortage, the pharmacy would automatically replace the order. It definitely worked, but I had one lady who wouldn't wake up after a 25 mg dose. There was no respiratory depression, but I sat with her for an hour doing my paperwork.....just to make sure!! She did get a really good sleep, though. LOL Anyway, Zofran seems to be the DOC at the moment where I work, also seems to work really well without the same side effects.

preciousnurse · Sep 12, 2002

Thanks shannon that was a helpful website. I know that this issue should not matter too much, but do you know how much Zofran costs vs. Phenergan? Cost effectiveness is a big thing these days, especially for the type of patients I sometimes see.

Nursekatie · Sep 12, 2002

ER/ nursing supervison here.......we use phenergan IV, some docs only use it IM. I have never had a bad reaction. Droperidol, is not available. I DID have bizarre reactions with that.........but IV benadryl would reverse the reaction. Zofran is actually a good anti emetic!!

AlaskanRN · Sep 12, 2002

Our ERdocs regularly order 12.5-25 mg phenergan. Although I am familiar with the restlessness and acting out behavior sometimes associated with it, I have never seen the resp depression you seem to have had. Now that I know what a problem it's been for you, I'll will keep a closer eye.