Promethazine (Phenergan)
ATI-format individual drug card with NCLEX-focused assessment, safety, teaching, and source attribution.
Promethazine (Phenergan)
ATI class: Antiemetic / Antihistamine
Action
- Blocks histamine receptors and reduces vestibular stimulation of the vomiting center.
- Has anticholinergic and sedating effects.
Therapeutic use
- Nausea and vomiting
- Motion sickness
- Allergic symptoms
- Sedation support when ordered
Nursing assessment
- Assess level of sedation, respiratory status, and fall risk.
- Check injection-site safety if parenteral therapy is ordered.
- Monitor anticholinergic effects such as dry mouth, urinary retention, constipation, and blurred vision.
Administration
- PO
- Rectal
- IM
- IV per strict facility policy
Side effects
- Drowsiness
- Dizziness
- Dry mouth
- Blurred vision
- Constipation
Adverse effects
- Respiratory depression, especially in young children or with other CNS depressants.
- Severe tissue injury with unsafe IV administration.
- Neuroleptic malignant syndrome or severe hypersensitivity are rare priority cues.
Interactions
- Alcohol
- Opioids
- Sedative-hypnotics
- Other anticholinergics
- MAOIs
Contraindications
- Children under 2 years old
- Lower respiratory tract symptoms or severe respiratory depression
- Comatose state
- Hypersensitivity to phenothiazines
Precautions
- Use caution with asthma, sleep apnea, glaucoma, BPH, seizure disorder, or older adult fall risk.
- Avoid combining with other CNS depressants unless specifically ordered and monitored.
Client teaching
- Avoid alcohol, driving, and hazardous activities until response is known.
- Report breathing difficulty, severe sedation, confusion, tissue pain/burning at IV site, or uncontrolled movements.
- Rise slowly and use fall precautions.
Medication outcomes
- Decreased nausea and vomiting
- Decreased motion sickness symptoms
Antidote / rescue
- No specific antidote is seeded; stop/question therapy and support airway, breathing, circulation, and seizure management for toxicity.
NCLEX priority cues
- Respiratory depression with a sedating antiemetic is an airway priority.
- IV-site burning or pain is urgent because severe tissue injury can occur.
- Do not treat a child under 2 with promethazine.
Medication classes
Source attribution
Related study cards
Shows the medication class, ATI cues, source references, and connected study cards for this drug.
Reduces nausea through different pathways, including serotonin, dopamine, histamine, muscarinic, cannabinoid, and NK1 receptor effects.
Blocks histamine effects; first-generation agents also cause sedation and anticholinergic drying.
ATI medication interaction concept.
ATI medication therapeutic use concept.
ATI medication class concept.
ATI medication class concept.
ATI medication nursing assessment concept.
ATI medication client teaching concept.
ATI medication precaution concept.
ATI medication mechanism of action concept.
ATI medication side effect concept.
ATI medication nursing assessment concept.