Promethazine Meperidine

During all valvuloplasty interventions antibiotics (e.g., cefuroxime, I, 5 g, i.v.) are administered. Patients allergic to penicillin should receive vancomycin I g intravenously. Most physicians perform transcatheter valvuloplasty in the fasting state under mild sedation, Substances that are frequently used are meperidine, promethazine, and chlorpromazine, given intramuscularly or intermittent doses of midazolam (0.05 to 0.1 mg/kg, i.v.) and/or fentanyl (0.5 to 1.0 Lig/kg, i.v.). Some operators also apply ketamine or general anesthesia for all interventional cases. 

The pharmacokinetics and effects of various systemically administered analgesics on the uterus, fetus, and neonate have been reviewed (SED-11, 137). Fetal bradycardia lasting up to 7 minutes was reported in 53 of 1910 fetuses (2.7%) after the administration of pethidine (meperidine) 75 mg and promethazine 25 mg intravenously to the mothers during labor (SED-11,137) (95). 

Ron M, Menashe M, Scherer D, Palti Z. Fetal heart rate decelerations following the administration of meperidine-promethazine during labor. Int J Gynaecol Obstet 1982 20(4) 301-5. 

Solt 1, Ganadry S, Weiner Z. The effect of meperidine and promethazine on fetal heart rate indices during the active phase of labor. Isr Med Assoc J 2002 4(3) 178-80. 

Brown ET, Corbett SW, Green SM. Iatrogenic cardiopulmonary arrest during pediatric sedation with meperidine, promethazine, and chlorpromazine. Pediatr Emerg Care 2001 17(5) 351-3. 

ASA with oxycodone (generic) MeperganFortis (Wyeth-Ayerst) Meperidine ft Promethazine S... 

Chlorpromazine increases the respiratory-depressant effects of meperidine, as do tricyclic antidepressants this is not true of diazepam. Concurrent administration of drugs such as promethazine or chlorpromazine also may greatly enhance meperidine-induced sedation without slowing clearance of the drug. Treatment with phenobar-bital or phenytoin increases systemic clearance and decreases oral bioavailability of meperidine this is associated with an elevation of the concentration of normeperidine in plasma. As with morphine, concomitant administration of an amphetamine has been reported to enhance the analgesic effects of meperidine and its congeners while counteracting sedation. 

Concurrent administration of drugs such as promethazine or chlorpromazine may greatly enhance meperidine-induced sedation without slowing clearance of the drug. 

Also analyzed acebutolol, acepromazine, acetaminophen, acetazolamide, acetophenazine, albuterol, amitriptyline, amobarbital, amoxapine, antipsrrine, atenolol, atropine, azata-dine, baclofen, benzocaine, bromocriptine, brompheniramine, brotizolam, bupivacaine, buspirone, butabarbital, butalbital, caffeine, carbamazepine, cetirizine, chlorqyclizine, chlordiazepoxide, chlormezanone, chloroquine, chlorpheniramine, chlorpromazine, chlorpropamide, chlorprothixene, chlorthalidone, chlorzoxazone, cimetidine, cisapride, clomipramine, clonazepam, clonidine, clozapine, cocaine, codeine, colchicine, qyclizine, (yclo-benzaprine, dantrolene, desipramine, diazepam, diclofenac, diflunisal, diltiazem, diphenhydramine, diphenidol, dipheno late, dipyridamole, disopyramide, dobutamine, doxapram, doxepin, droperidol, encainide, ethidium bromide, ethopropazine, fenoprofen, fentanyl, flavoxate, fluoxetine, fluphenazine, flurazepam, flurbiprofen, fluvoxamine, fii-rosemide, glutethimide, glyburide, guaifenesin, haloperidol, homatropine, hydralazine, hydrochlorothiazide, hydrocodone, hydromorphone, hydro g chloroquine, hydroxyzine, ibuprofen, imipramine, indomethacin, ketoconazole, ketoprofen, ketorolac, labetalol, le-vorphanol, lidocaine, loratadine, lorazepam, lovastatin, loxapine, mazindol, mefenamic acid, meperidine, mephenytoin, mepivacaine, mesoridazine, metaproterenol, methadone, methdilazine, methocarbamol, methotrexate, methotrimeprazine, methoxamine, methyl-dopa, methylphenidate, metoclopramide, metolazone, metoprolol, metronidazole, midazolam, moclobemide, morphine, nadolol, nalbuphine, naloxone, naphazoline, naproxen, nifedipine, nizatidine, norepinephrine, nortriptyline, oxazepam, oxycodone, oxymetazo-line, paroxetine, pemoline, pentazocine, pentobarbital, pentoxifylline, perphenazine, pheniramine, phenobarbital, phenol, phenolphthalein, phentolamine, phenylbutazone, phenyltoloxamine, phenytoin, pimozide, pindolol, piroxicam, pramoxine, prazepam, prazosin, probenecid, procainamide, procaine, prochlorperazine, procyclidine, promazine, promethazine, propafenone, propantheline, propiomazine, propofol, propranolol, protriptyline, quazepam, quinidine, quinine, racemethorphan, ranitidine, remoxipride, risperidone, salicylic acid, scopolamine, secobarbital, sertraline, sotalol, spironolactone, sulfinpyrazone, sulindac, temazepam, terbutaline, terfenadine, tetracaine, theophylline, thiethyl-perazine, thiopental, thioridazine, thiothixene, timolol, tocainide, tolbutamide, tolmetin, trazodone, triamterene, triazolam, trifluoperazine, triflupromazine, trimeprazine, trimethoprim, trimipramine, verapamil, warfarin, xylometazoline, yohimbine, zopiclone... 

Noninterfering acetaminophen, aspirin, amitriptyline, huprenorphine, caffeine, carba-mazepine, chlorpromazine, desipramine, dextromethorphan, doxepin, ephedrine, fenfluramine, imipramine, lidocaine, loxapine, meperidine, methadone, methaqualone, naloxone, naltrexone, nicotine, orphenadrine, oxycodone, papaverine, pentazocine, phendimetra-zine, phenmetrazine, phentermine, phenylpropanolamine, phenytoin, primidone, procaine, promethazine, propoxyphene, propyphenazone, theobromine, theophylline, trazodone, triflupromazine, trimethoprim, trimipramine... 

Extracted amitriptyline, benztropine, brompheniramine, chlorpheniramine, chlorproma-zine, clomipramine, ( roheptadine, desipramine, diphenhydramine, dothiepin, doxepin, haloperidol, imipramine, loxapine, maprotiline, meperidine, mesoridazine, methadone, metoclopramide, mianserin, moclobemide, nomifensine, nordoxepin, norfluoxetine, nor-propo q)hene, northiaden, nortriptyline, pentoharhital, pheniramine, promethazine, propoxyphene, propranolol, protriptyline, quinidine, quinine, sulforidazine, thioridazine, thiothixene, tranylcypromine, treizodone, trihe q)henidyl, trimipramine, triprolidine Noninterfering dextromethorphan, norphetidine, phenoxyhenzamine, prochlorperazine, trifluoperazine Interfering amoxapine... 

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