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Promethazine

Promethazine is an antihistamine. It is used for the symptomatic treatment of allergic diseases. It was earlier used for the potentiating of anesthesia.

In the 1940s many pharmaceuticals firms were engaged in finding the medicines that would block the action of histamine. Among them was French pharmaceutical firms “Special”, reasearching antihistamine activity of phenotiazine derivatives. It was suddenly discovered that the antihistamine of this class of compounds- promethazine, apart from its own antihistamine effect, can have a calming effect on the patients, cause retardation and even drowsiness. This effect of promethazine was initially considered side effect, until in 1950 French military doctor Anri Mari Laborit hasn’t noted the possibility of using hindering effect of the drug in anesthesiology. Thanks to promethazine and other phenotiazine derivates, the doctors have managed to suppress hormonal reaction of neuroendocrine glands on the operative trauma. In some cases anaesthetic effect of the drugs was so strong, that the patients didn’t need morphine after operation.

Indications for use

Diprazine is used for the treatment of allergic diseases (urticaria, serum sickness, hay fever, etc.), vasomotor and allergic rhinitis, rheumatism with the pronounced allergic component, allergic complications, caused by penicillin, streptomycin and other medicines, as well as the itching dermatitis, Meniere’s disease, choreia, encephalitis and other CNS diseases, accompanied by the enhancement of the permeability of vessels, sea and air sckness. In surgical practice Diprazine is used as one of the main components of lytic compositions, used for the potenthiated anesthesia and hypothermia, for the prevention and reducing of postoperative complications, during the operation and in postoperative period. It is also used to increase the action of analgesics and local anesthetics.

Special indications

During the long-term treatment it is necessary to do the CBC blood test and assess the liver function systematically. During the further treatment the degree of restriction is determined according to the intolerance. Together with the narcotic analgesics, anxyolithics- for the complex pre-operative preparation of patients, is used under the strict doctor’s supervision. It is forbidden to use ethanol at the time of treatment. In old age, one must be cautious by the parenteral administering of high doses, as the extrapyramidal disorders and acute urinary retention. The use of promethazine in children under 2 years can be accompanied by the increased frequency of night apnea attacks. As the the antiemetics, it is necessary to use it only for the prolonged vomiting of known origin. The long-term treatment increases risk of developing dental diseases (caries, periodontitis, and candidiasis) because of decreased salivation. During the treatment you can get the false positive results of pregnancy test. In the initial, individually determined treatment period, one must be cautious while driving a car and the engage in potentially dangerous activities, requiring the high level of concentration, attention and prompt psychomotor reactions.

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