UMEM Educational Pearls

Category: Toxicology

Title: Follow Up on Phenergan IV - Why Not IM

Keywords: promethazine (PubMed Search)

Posted: 10/25/2013 by Fermin Barrueto, MD (Updated: 12/7/2019)
Click here to contact Fermin Barrueto, MD

Yesterday's pearl generated several questions that I thought were worth answering briefly:

1) Why give it IM? Absorption rate is faster than SQ infiltration though theoretically could still cause necrosis

2) Is it only infilitration? Gangrene has occurred with inadvertent intra-arterial injection, SQ infiltration and even regular IV administration

3) Mechanism? Appears to be the drug and not diluent, diluting down the concentration as well as decreasing dose appears to help if you are going to give it IV

Here is a website if you wish to read more details:

https://www.ismp.org/newsletters/acutecare/articles/20060810.asp