Doctor insights on:
What other antihistamine has antiemetic properties equivalent or superior to phenergan (promethazine)?
Several good ones: But best depends on cause of emesis: viral/bacterial gastroenteritis/food poisoning: emetrol, pepto-bismol, kaopectate; dizziness/seasickness: dramamine, (dimenhydrinate) bonine. Precautions: emetrol used with caution in diabetics; pepto causes black tongue/mouth/stools; dramamine/bonine can cause drowsiness & may exacerbate glaucoma. If in doubt, ask your fp/pediatrician. ...Read more
Among other things: Phenergan (promethazine) is a phenothiazine (most of the family are anti-psychotics) which is used primarily for its antihistaminic, antiemetic, & sedative effects. Because it also blocks acetylcholine, it can cause dry mouth, blurred vision, constipation, difficulty urinating. As a phenothiazine it may cause uncontrollable movement disorders (extrapyramidal reaction). Also a photosensitizer. ...Read moreSee 1 more doctor answer
Is it true that opioids in higher doses have antiemetic effects vs lower doses because it depresses the vomiting center?
yes: High doses of some opioids may decrease n/v by interacting with receptors in the vomiting center, rather than the ctz (chemoreceptor trigger zone ).The relationship between opioids use and n/v is complex. The vomiting center in the medulla oblongata, receives input from 4 areas; chemoreceptor trigger zone gi tract vestibular apparatus -temporal lobe cerebral cortex. ...Read more
Palliative sedation : Sedation use to relieve refractory symptoms is often indicated in palliative treatment of dying patients. Inoperable malignant intestinal obstruction or advanced malignant cancer is the most common cause of intractable vomiting. Medications such as Midazolam & propofol, +/- haloperidol are often used for this purpose and work by creating a medication induced coma. Life expectancy is 3-4 days. ...Read more
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