Promethazine (Phenergan), prochlorperazine (Compazine), and metoclopramide (Reglan) can cause neuroleptic malignant syndrome, a rare and life-threatening side effect in which dangerously high body temperatures can occur.
Promethazine (Phenergan) and prochlorperazine (Compazine) may cause neutropenia, a decrease in the number of neutrophils (white blood cells), putting the patient at a higher risk for infections.
When given by IV push, undiluted promethazine has been associated with severe tissue necrosis.
Respiratory depression (decreased drive for breathing) is a life-threatening effect that can occur with cyclizine (Mariezine), promethazine (Phenergan), and scopolamine (L-hyoscine).
Use your stethoscope to listen for active bowel sounds.
Assess for abdominal distention.
If the patient is prescribed metoclopramide (Reglan), has whether he or she has experienced depression in the past. If so, notify the prescriber before giving the drug.
If the drug is to be given IV, be sure to dilute it first to decrease the risk of tissue necrosis.
Recheck the patient’s temperature, BP, HR and rhythm, and respiratory rate.
Obtain daily weights.
Continue to listen for active bowel sounds and assess for abdominal distention.
Ask the patient about nausea and vomiting at least every shift.
Monitor for respiratory depression. Immediately report any of these signs to the prescriber.
Watch for signs of side effects or adverse effects. Report immediately to prescriber.
Keep track of input and output (both food and fluid). Ask about GI upset.
Watch for signs of depression in patients taking metoclopramide (Reglan).
Warn patients that prochlorperazine (Compazine) may cause urine to change color to pink or reddish-brown. This condition usually disappears within a few days after the drug is discontinued.
Tell patients about eating foods with increased bulk and about the importance of drinking enough fluids to prevent constipation. Explain that moderate exercise may also help prevent the side effect of constipation.
Remind patients that for best control of nausea or vomiting, antiemetic drugs should be taken before events that usually cause nausea.
Advise against using CNS depressants such as alcohol, antihistamines, sedatives, tranquilizers, or sleeping drugs while taking antiemetic drugs.
Suggest the use of a mild analgesic such as acetaminophen for relief from headaches.
Metoclopramide passes into the breast milk and should be avoided while breast feeding.