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Promethazine/ Phenergan
Promethazine/ Phenergan
Low dose can be 12.5MG to
–25 MG. Intravenous push over 5 minutes is
1ML
IVP/(means IV push in your IV.) Works best in a bigger vein. We highly suggest that you do not have this medication pushed in your Peripheral vein location of your hand, wrist , or any vein below the elbow. It can blow your vein and cause tissue damage. *IV dose contains sulfite
12.5–25 mg orally, if patient is vomiting IV dosing is best .
Intramuscular injections are administered at a 90-degree angle to the skin, preferably into the anterolateral aspect of the thigh or the deltoid muscle of the upper arm, depending on the age of the patient. The needle gauge for intramuscular injection is 22-25 gauge.
I.M every 4-6 hours.
NEW Research Warning from HELP HER: IV or injected doses can cause tissue damage. More info available on fda.gov. GIVE IV dose SLOWLY to avoid contractions. Push over 5 minutes.
Side-effects of anxiety, sedation, and restlessness common and may limit use. Dilute in sodium chloride 0.9% 9 ML of saline 1ML of medication.
Kytril, Sancuso, Granisetron
1 mg every 12 hours (IV or orally) Allows twice a day dosing. Also available in transdermal patch form
Thorazine (Chlorpromazine)
Oral/IM 12.5–25mg every 4–6 hours. Rectal 50–100 mg every 6–8 hours. May increase risk of fetal malformations. May cause muscle spasms in neck/face and/or difficulty with speech. Research articles on PubMed.
Haldol (Haloperidol)
1–2 mg orally/IM every 8 hours Extrapyramidal symptoms (EPS) more common. May cause constipation. Research articles on PubMed.
RESEARCH THIS LAST RESORT
Medications for Battery Acid Heartburn
Zantac (Ranitidine) 50 mg IV every 8 hours or 150 mg orally daily or twice a day. **THIS WAS PULLED OFF THE MARKET **
Pepcid (Famotidine) 20 mg IVP/orally every 12 hours.
Prevacid (Lansoprazole) 30-60 mg/day.
PROTONIX I.V. for Injection may be administered intravenously through a dedicated line or through a Y-site. The intravenous line should be flushed before and after administration of PROTONIX I.V. for Injection with either 5% Dextrose Injection, USP, 0.9% Sodium Chloride Injection, USP, or Lactated Ringer's Injection, USP. When administered through a Y-site, PROTONIX I.V. for Injection is compatible with the following solutions: 5% Dextrose Injection, USP, 0.9% Sodium Chloride Injection, USP, or Lactated Ringer's Injection, USP.
Midazolam HCl has been shown to be incompatible with Y-site administration of PROTONIX I.V. for Injection. PROTONIX I.V. for Injection may not be compatible with products containing zinc. When PROTONIX I.V. for Injection is administered through a Y-site, immediately stop use if precipitation or discoloration occurs.
Antihistamines & Corticosteroids
Bonine, Antivert, Marezine
Follow directions on the label.
Dramamine (Dimenhydrinate)
50-100 mg every 4-6 hours used for motion sickness.
Unisom
25 mg orally at bedtime, 1/2 tablet every 6 hours as needed.
Component of Diclegis/Diclectin.
UNISOM is often taken with vitamin B6 they now have it as a pill combined as a pill and gos by the names Diclectin, Diclegi
Doxylamine plus Pyridoxine
Average dose is 1 tablet in morning, one in afternoon and two at night. May be given in higher doses up to 12 tablets daily - see research links on right. Differs from Unisom/B6 combo because it isa delayed release formula.
Benadryl (Diphenhydramine or Gravol)
25 mg IVP/orally every 4–6 hours. Benadryl and Phenergan combined in an IV helps many HG mothers relax and sleep for a short time to have a reprieve, or Zofran and Benadryl both at the sametime.
Disclaimer:
If you have never had Benadryl make sure it is pushed slowly over a course of 3-5 mintues until you know how you will react ,
Corticosteroids/Cortisone
Not recommended until after 8-10 weeks, however, the benefit may outway the risk, please talk with your doctor if you are very sick. Can cause birth defects if used earlier but has helped many HG mothers with extreme HG symptoms - Used for refractory Hyperemesis Gravidarum, usually in conjunction with Ondansetron/Zofran - Possible side-effects: blood sugar instability, weight loss, nausea and vomiting, increased risk of preeclampsia - Possible fetal complications: reduced birth weight, clefts (if early use), adrenal insufficiency (if exposed to large doses) - Inconclusive concerns over impact on fetal brain development and oral/lip clefts with prolonged dosing at high levels, and use during the first trimester.
Remeron
Tigan (Trimethobenzamide)
Diclegis/Diclectin
Comes in pill form for HG has not been determine also works intravenous. Helps nausea and vomiting in some case studies.
Diclegis/Diclectin
Tigan (Trimethobenzamide)
Diclegis/Diclectin
For treatment of nausea in pregnancy the return to the USA of doxylamine-pyridoxine delayed release combination Diclegis® was made for morning sickness and morning sickness and HG are NOT one and the same and many medical doctors are still learning this. For some women this works and some it doesn't. They took the B6 and Unisom and made it into one pill called Diclegis. Some HG mothers that have light HG said it helped and mothers with severe HG nothing helps.
Tigan (Trimethobenzamide)
Tigan (Trimethobenzamide)
Vistaril, Atarax (Hydroxyzine)
25 mg orally every 6-8 hours 200 mg IM every 6-8 hours.
Vistaril, Atarax (Hydroxyzine)
Vistaril, Atarax (Hydroxyzine)
Vistaril, Atarax (Hydroxyzine)
25 mg orally every 6 hours syrup available. Helpful for insomnia.
Benadryl and Zofran
Vistaril, Atarax (Hydroxyzine)
Gabapentin (Neurontin)
Sometime the two medications together can help a HG mother fall asleep for a some time to stop the vomiting and severe nausea.
25-50 mg of IV Benadryl
4 ml of Zofran
Gabapentin (Neurontin)
Vistaril, Atarax (Hydroxyzine)
Gabapentin (Neurontin)
In trials for use in HG. Considered as last resort in patients who have exhausted other medication categories. There are some facebook groups with mothers trying this, message if you need a link. Very helpful for some mothers.