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Functional Class
Anti-emetic, phenothiazine, antihistamine, anti-cholinergic
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Mechanism of Action
Decreases nausea by blocking dopamine and H1 receptors associated with vagal stimulation of the emesis center in the medulla. Also decreases effects of muscarinic receptors in the GI thus decreasing gastric secretions and peristalsis.
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Contraindications
- Hypersensitivity
- Less than 2 years old with emesis due to respiratory depression
- Hypotension
- Use in with CNS depressants
- Decreased LOC
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Precatautions
MAOIs, anticholinergics, pregnancy/lactating mothers
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Side Effects
- Sedation
- Dystonic reaction
- Tremors
- Dizziness
- Blurred vision
- Diplopia
- Tinnitus
- Tissue necrosis if given SC
- Lowers seizure threshold
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Interactions
MAOIs, antagonizes effects of epinephrine
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Dosage and Route
Adult: 6.25 mg slow IVP or 12.5 mg IM q 4 hours
Pediatric: 0.25 mg/kg IV/IM
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Pharmacokinetics
- Onset: 5 mins IV, 20 mins IM
- Duration: 4-6 hours
- Half-life: 9-16 hours
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Note
May use diphenhydramine for dystonic reactions
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