異丙嗪

用途

• As an antiemetic
• As an antihistamine
• As an antihistamine
• As an antiemetic
• As an antihistamine
• As an antihistamine

給藥方式

可能的副作用

• Sedation or lethargy
• Anticholinergic effects (dry mouth, urinary retention, decreased GI motility)
• Hypotension (especially with rapid IV administration or in hypovolemic patients)
• Extrapyramidal signs (tremors, rigidity, torticollis) - rare but possible
• Sedation / Lethargy
• Dry mucous membranes (anticholinergic effect)
• Tachycardia
• Hypotension
• Paradoxical excitation (especially in cats)
• Gastrointestinal disturbances

注意事項與禁忌

• Hypovolemia or shock (due to hypotensive effects)
• Tetanus or strychnine intoxication (due to extrapyramidal effects)
• Human label black box warning: Contraindicated in children < 2 years old (fatal respiratory depression)
• Known hypersensitivity to phenothiazines
• Severe central nervous system depression
• Comatose patients
• Use with caution in patients with seizure disorders
• Use with caution in patients with severe hepatic or cardiovascular disease
• Use cautiously and at smaller doses in animals with **hepatic dysfunction**, **cardiac disease**, or general debilitation. Animals may require lower dosages of general anesthetics following phenothiazine administration. Use with extreme caution in very young or severely debilitated animals. Promethazine can cause false-positive results for salicylates in urine and false-positive/negative results for chorionic gonadotropin in urine.

藥物相互作用

• Antacids: May cause reduced GI absorption of oral phenothiazines.
• Antidiarrheal mixtures (e.g., Kaolin/pectin, bismuth subsalicylate): May cause reduced GI absorption of oral phenothiazines.
• Atropine & other anticholinergics: May have additive anticholinergic effects when used with promethazine.
• CNS Depressant Agents (barbiturates, narcotics, anesthetics): May cause additive CNS depression if used with phenothiazines.
• Epinephrine: Phenothiazines block alpha-adrenergic receptors; concomitant epinephrine can lead to unopposed beta-activity causing vasodilation and increased cardiac rate (epinephrine reversal).
• Metoclopramide: Phenothiazines may potentiate the extrapyramidal effects of metoclopramide.
• Monoamine Oxidase Inhibitors (MAOIs): May potentiate extrapyramidal effects.
• Opiates: May enhance the hypotensive effects of phenothiazines; dosages may need to be reduced.
• Organophosphate Agents: Phenothiazines should not be given within one month of worming with these agents as their toxic effects may be potentiated.
• CNS Depressants (e.g., opioids, barbiturates, anesthetics): Additive central nervous system depression and sedation.

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