IV Phenergan

Nurses General Nursing

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sillyang

26 Posts

Specializes in soon cwocn.

I had a patient who received IVP dilaudid follwed by IVP phenergan every 4 hour prn, the patient had a port a cath. The patient had been receiving it this way for a long time even at home ( the spouse was giving it). The policy at work has changed now and we hang it in 50cc NS. The patient has made a recent return visit and was not happy with the policy change. I think the patient liked the comatose effect.

Specializes in ICU, Telemetry, Neuro, Ortho, Med/Surg.

We also have to mix it in a 50 ml NS bag. A good many patients who say "nothing else works but Phenergan" do not like that very much.

Specializes in Med Surg, Ortho.

It's banned in our hospital except for IM or PO.

paranrs66

16 Posts

Specializes in ER, ICU, Home, pre-hospital.

I have had an IM phenergan shot in the buttocks for uncontrolled N&V just a couple years ago at a doc in a box, owwwie, hopefully no one would give that in the arm, especially over and over...Also, learned 10 yrs. ago this med should be diluted when given thru a vein, especially over and over, and who assumes a vein is patent? Always check for patency no matter what the IV med. Our system uses zofran mostly now anyway. Cheers!

pers

517 Posts

We were just discussing this at work and I thought perhaps I was crazy! We give this routinely on my unit and I clearly remember warnings from school about how dangerous it is so have always been cautious.

The other night I was pushing over 10 mins when another nurse came to get me for something, I explained I would be out in a bit as I was pushing phenergan. Two or three minutes later she came back and I again said I'd be out in a few more minutes. When I finally made it out to the desk, she asked me why I took so long to push phenergan and I told her all the warnings I'd heard and that it was supposed to be pushed that slow per Davis's drug guide. She said she had always pushed it over just a minute or two and looked in another drug book (Mosby I think) and it did say that it could be given over one minute. We checked another drug book and it gave both the one minute and the ten minute suggestion so we called the pharmacy. They said that one minute seemed a little fast but ten minutes was excessive and suggested it be given over two minutes. I can't bring myself to go that quick but do give it over closer to seven or eight minutes now instead of the full ten and check the IV very carefully first.

Annisme

161 Posts

Specializes in med/surg, ER.

I give 12.5 mg MAX iv, diluted in 10 ml NS, IV not in the hand or wrist, and with a NS bolus running, per our facility policy. I still push it v-e-r-y slowly.

Specializes in PACU.

I like it assuming that the patient isn't already excessively sedated. I don't like it as a first-line anti-emetic but it is great when Zofran and Reglan have failed. I, too, dilute it at a max concentration of 12.5 mg in 10 ml and then I push it over about 5 minutes into a line running wide open.

Spritenurse1210, BSN, RN

1 Article; 777 Posts

Specializes in Med/Surg.

We give it in 50ml normal saline if we give it at all. I haven't seen any ill effects since we have been administering Phenergan IV this way. I just happened to read some of the effects of the drug and was FLOORED. I can't believe people actually lose limbs because of the stuff!

ChristaRN

68 Posts

Specializes in PICU now, Peds and med-surg in the past.

I used to LOVE this stuff. Several years back in a previous nursing life I worked with alot of GYN oncology patients and their docs routinely would prescribe it. It worked wonders for them! I used to dilute it in 10 ml of NSS and push over about 3 minutes. Knock on wood, I never had a patient encounter a problem. When the hospital I worked at put it on a majorly restricted list and I did my own research I was SHOCKED! The antiemetic I am most familliar with now is Zofran for basically all patients, whether they be post op, GI bug or oncology. I have noticed for my onco kids that Zofran doesn't tend to do enough to kick their nausea, at least not for a long enough period that they can have it again right away - usually about 3 hours later they or there parents will be calling for more medicine. Many of our oncology patients seem to prefer benadryl or ativan for their antiemetic properties and our oncologists will at times prescribe compazine for the kids who just aren't helped by Zofran. In my own practice I have noticed many more patients telling me that Zofran didn't help enough then I ever heard with Phenergan.

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