It’s not enough to develop drugs for cancer. We have to develop plans to help improve lives

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Senior Vice President of Oncology at Astellas Pharma

Tens of thousands of researchers, clinicians, and industry leaders descended upon Chicago for the annual meeting of the American Society of Clinical Oncology (ASCO), where breakthrough science and promising statistics in cancer care were on full display.

The Annual Report to the Nation on the Status of Cancer, published this spring by the Centers for Disease Control and Prevention, the American Cancer Society and other public and private-sector organizations, showed that mortality rates for the most common cancers in men and women, including lung, colorectal, female breast, and prostate, have continued to decline. With the exciting progress we’re seeing in immunotherapies, personalized medicine and other therapeutic areas, there is every reason to believe that meaningful progress will continue well into the future.

However, defeating cancer is about more than breakthroughs or statistics alone. In the midst of all the scientific excitement, we must not lose sight of the fact that a disease like cancer, even if treatments are ultimately successful, fundamentally changes the life of the person battling it.

Those of us who have devoted our careers to changing lives need to define “life” in a holistic way, beyond the cellular level. This begins with supporting ways to reduce the impact of cancer treatments on patients. At Astellas, our team is deeply encouraged by what we’ve seen, for example, in the use of virtual reality to help people better manage the high degrees of stress that accompany treatment. What’s more, the continuing proliferation of online and community-based support networks is increasingly helping to ensure that people fighting this disease never have to feel alone.

Even beyond that, though, we need to focus our ideas and energies on how we can help cancer patients regain the lives that the disease stole from them. We’re learning more about the benefits of helping people process the emotions they experience during diagnosis and treatment, establish post-treatment plans, and rebuild their confidence regarding career, education, finances, and relationships.

As a company and industry, one of the most important things we can do to help achieve this holistic approach to cancer care is put ourselves squarely in the shoes of those fighting the disease. Not too long ago, this hit close to home when my father was diagnosed with head and neck cancer and my perspective of our healthcare system completely changed. Although I had been working in the industry for more than 20 years, I found myself confused and frustrated when I was put into the caregiver role. As I attempted to navigate the system and coordinate the right care for my father, I was met with both discrepancies in treatment options and constant misunderstandings.

My experience as a caregiver reinforced my view that we must ask patients and their caregivers about their lives with the disease and how it has affected them on a daily basis. Only then can we truly understand the impact of the disease and help patients live fully after their diagnoses.

In 2015, Astellas co-developed a prospective patient registry for individuals with castration-resistant prostate cancer (CRPC). The program, Treatment Registry for Outcomes in CRPC Patients (TRUMPET), is designed to follow 1,200 patients for up to six years and evaluate each patient’s clinical and quality of life experience with the disease. With more than 600 CRPC patients already enrolled, TRUMPET helps us understand how these men manage CRPC, navigate the healthcare system, and make treatment decisions with family and caregivers. Importantly, it helps us shape future research and allows our company to make use of real world evidence with patient outcomes and quality of life in mind.

I’m both encouraged and excited that cancer is losing ground every day to our scientific progress. The major breakthroughs and the continual incremental successes are critically important. But I also believe that we, combined with other leaders across healthcare, have the obligation, will and the resources to achieve the most important victories – helping individuals regain the bright outlook they had before the day they received that life-altering diagnosis.

As we celebrate all the exciting research and advances shared at ASCO this week, let’s also be sure to keep this bigger picture in mind.

This post was originally published on The Astellas Way.

Medical errors now third leading cause of death in United States

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May 3, 2016

These common medical errors are major killers

Play Video1:16
A new study by patient safety researchers shows common medical errors may be the third leading cause of death in the U.S., after heart disease and cancer. (Deirdra O’Regan/The Washington Post)

Nightmare stories of nurses giving potent drugs meant for one patient to another and surgeons removing the wrong body parts have dominated recent headlines about medical care. Lest you assume those cases are the exceptions, a new study by patient-safety researchers provides some context.

Their analysis, published in the BMJ on Tuesday, shows that “medical errors” in hospitals and other health-care facilities are incredibly common and may now be the third-leading cause of death in the United States — claiming 251,000 lives every year, more than respiratory disease, accidents, stroke and Alzheimer’s.

Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine who led the research, said in an interview that the category includes everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another.

“It boils down to people dying from the care that they receive rather than the disease for which they are seeking care,” Makary said.

The issue of patient safety has been a hot topic in recent years, but it wasn’t always that way. In 1999, an Institute of Medicine report calling preventable medical errors an “epidemic” shocked the medical establishment and led to significant debate about what could be done.

The IOM, based on one study, estimated deaths because of medical errors as high as 98,000 a year.  Makary’s research involves a more comprehensive analysis of four large studies, including ones by the Health and Human Services Department’s Office of the Inspector General and the Agency for Healthcare Research and Quality that took place between 2000 to 2008. His calculation of 251,000 deaths equates to nearly 700 deaths a day — about 9.5 percent of all deaths annually in the United States.

Makary said he and co-author Michael Daniel, also from Johns Hopkins, conducted the analysis to shed more light on a problem that many hospitals and health-care facilities try to avoid talking about.

Although all providers extol patient safety and highlight the various safety committees and protocols they have in place, few provide the public with specifics on actual cases of harm due to mistakes. Moreover, the Centers for Disease Control and Prevention doesn’t require reporting of errors in the data it collects about deaths through billing codes, making it hard to see what’s going on at the national level.

The CDC should update its vital statistics reporting requirements so that physicians must report whether there was any error that led to a preventable death, Makary said.

“We all know how common it is,” he said. “We also know how infrequently it’s openly discussed.”

Kenneth Sands, who directs health-care quality at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School, said that the surprising thing about medical errors is the limited change that has taken place since the IOM report came out. Only hospital-acquired infections have shown improvement. “The overall numbers haven’t changed, and that’s discouraging and alarming,” he said.

Sands, who was not involved in the study published in the BMJ, formerly known as the British Medical Journal, said that one of the main barriers is the tremendous diversity and complexity in the way health care is delivered.

“There has just been a higher degree of tolerance for variability in practice than you would see in other industries,” he explained. When passengers get on a plane, there’s a standard way attendants move around, talk to them and prepare them for flight, Sands said, yet such standardization isn’t seen at hospitals. That makes it tricky to figure out where errors are occurring and how to fix them. The government should work with institutions to try to find ways improve on this situation, he said.

Makary also used an airplane analogy in describing how he thinks hospitals should approach errors, referencing what the Federal Aviation Administration does in its accident investigations.

“Measuring the problem is the absolute first step,” he said. “Hospitals are currently investigating deaths where medical error could have been a cause, but they are underresourced. What we need to do is study patterns nationally.”

He said that in the aviation community every pilot in the world learns from investigations and that the results are disseminated widely.

CONTENT FROM THE CLEVELAND CLINIC
Why empathy matters in healthcare
More hospitals are putting patient comfort and wellbeing at the forefront of their operations—from staff hires to building design to team structure.

“When a plane crashes, we don’t say this is confidential proprietary information the airline company owns. We consider this part of public safety. Hospitals should be held to the same standards,” Makary said.

Frederick van Pelt,  a doctor who works for the Chartis Group, a health-care consultancy, said another element of harm that is often overlooked is the number of severe patient injuries resulting from medical error.

“Some estimates would put this number at 40 times the death rate,” van Pelt said. “Again, this gets buried in the daily exposure that care providers have around patients who are suffering or in pain that is to be expected following procedures.”

New USB id & Medical Data Wearable

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USB id & Medical Data Wearable
Order Your’s http://USBidentification.com

USB Information Wearable

EPIC-id+ offers the advantages of an Engraved Emergency ID along with three digital pages of your most critical medical information on a waterproof USB. EMS, firefighters and police are trained to look for emergency ID bands. When first responders read your engraved ID and connect EPIC-id to their on-board computers, they immediately have your medical and contact information available in both a physical and digital format.

USB Identification - Daily Marketing Services

Keep Safe

Digital emergency forms come pre-loaded on EPIC-id, making it simple to input your personal medical information and make updates as often as necessary. No software to download. No subscriptions to pay.

Easy for First Responders

EMS, firefighters and police are trained to look for emergency ID bands. When professional first responders read your engraved tag and connect EPIC-id to their on-board computers to access your medical information, you have the benefit of having your medical information available in both a physical and digital format.

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EPIC-id Engraved ID Tag

Custom Engraved ID Tag

Whats Cookin Nashville Gold Line

Order your’s today – $49.95 – Free Shipping
Order at http://USBIdentification.com
615-673-1112

Nashville Community Outreach

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Ashley’s Voice Community Outreach Group

Daily Marketing Services supports the non-profit Community Outreach group “Ashley’s Voice”. Ashley’s Voice provides Community Service information to the residents of Nashville and Middle Tennessee. Connecting the Dots to helping people find the free services they need. Services include Medical Services, Palliative Care, Hospice, Caregivers, Victims of Violent Crimes, Veterans Benefits, Grief Counseling and Medicaid. Information – 615-673-2221

Ashley's Voice Outreach Group.jpg

About Alive Hospice

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Lean on us when heartbreak and healing go hand in hand.
About Alive Hospice Nashville TN.

Ashley’s Voice Outreach Group
Would you like to ask questions about Hospice – Ashley’s Voice Outreach – 615-673-2221

Alive Hospice Nashville TN

Alive Hospice is a nonprofit organization that provides compassionate end-of-life care, palliative care, bereavement support and community education. Founded in Middle Tennessee in 1975, Alive Hospice is accredited by The Joint Commission and has held its Gold Seal of Approval for many years. It is also accredited by the National Institute for Jewish Hospices.

Alive Hospice entered the Middle Tennessee landscape in November 1975, only one year after the founding of the first hospice program in the United States. At the time, and through grassroots movements, other hospices also began appearing across the country. Like the group of individuals gathered together by Alive Hospice’s founders, Dr. David Barton and the late Dr. John Flexner, what unified those movements was compassionate people committed to helping patients live in comfort until death occurred and families to grieve with support.

Alive Hospice was chartered in 1975 as a nonprofit organization dedicated with three core goals: providing comprehensive care for terminally ill patients and their families; offering support for grieving adults and children; and serving the community as a center for research and education.

Today, Alive Hospice serves more than 3,600 patients and their families annually (more than 430 daily) and provides grief support services for nearly 600 adults and children in Middle Tennessee in addition to training for tomorrow’s caregivers and education for the community at large.


Our mission

We provide loving care to people with life-threatening illnesses, support to their families

and service to the community in a spirit of enriching lives.

Our vision

To be recognized as expert providers of hospice care, palliative care, management of

advanced disease and grief support and to be the agency of choice for the provision of

these services.

To be recognized as innovators and leaders in all aspects of end-of-life resources.
To influence the perceptions within the community and among medical professionals so

that the end of life is accepted as a meaningful component of the human experience.

Our values

We believe death to be a natural part of life’s journey.

We believe in honesty and integrity in all we say and do.

We believe in compassion to those we serve and to each other.

We believe in respect and dignity for all.

We value competent knowledgeable staff motivated to achieve personal and

professional growth.

We believe in accountability to society, our community and each other.

We believe in responsible stewardship of the resources with which we have been entrusted.

We believe in the continuous pursuit of organizational excellence.

We believe in teamwork to achieve our vision and mission, and to support our values.

Statement of Inclusiveness

As the only not-for-profit, community-based hospice in Middle Tennessee, Alive Hospice never turns anyone away, regardless of ability to pay, insurance status, race, religion, creed, color, sex, age, national origin, veteran status, sexual orientation, or disability.  We live our mission to provide loving care to people with life-threatening illnesses, support to their families, and service to the community in a spirit of enriching lives.

Nashville Victim Intervention Program

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Victim Intervention Program (VIP)

“Putting Lives Back Together”

Want to ask questions about V.I.P ? Call Ashley’s Voice Outreach – 615-673-2221

When Someone You Know Is Touched By Crime

Victim Intervention Program logoWhenever a crime occurs, many people are affected — the victim, family members, friends and the entire community. The latest national statistics show that one out of four families in the United States will be touched by violent crime every year. Moved by the very real suffering of the people who make up these alarming figures, the Nashville Police Department developed the Victim Intervention Program as a way to help restore a sense of peace and balance to lives torn apart by violent crime.

The mission of the Victim Intervention Program of the Metropolitan Nashville Police Department is to provide mental health services and criminal justice system advocacy whenever individuals, families, and/or the community are affected by violent crime. All services are free, confidential, and provided in an environment which supports cultural diversity: with respect to race, religion, creed, and sexual orientation.

Help Is Here

The Victim Intervention Program (VIP) was first launched in 1975 as a crisis counseling and victim advocacy program. VIP was founded on the idea that anyone who endures a trauma as a result of a criminal act should be offered free and immediate crisis intervention and follow up counseling. Staffed by mental health professionals, VIP is available to victims, their families, and other individuals in crisis who come in contact with the police department. Anyone victimized by a crime who wants counseling or court advocacy is eligible for services. A victim’s decision about prosecution does not affect eligibility.

A Wide Range of Services

As the number of violent crimes has continued to climb, the Victim Intervention Program has added services to fill a growing need. A professional and compassionate staff provides:

Crisis Intervention

A 24-hour on call service to victims and citizens involved in crimes reported to the police department.

Counseling

Professional counseling services to individuals, family members and others affected by crime and traumatic police related events. Support groups for victim populations are provided at various times throughout the year and referral services when appropriate.

Critical Incedent Debriefings

Group crisis intervention provided upon request when businesses, schools, or other groups are affected by violence.

Advocacy

Guidance, support, clarification and explanation throughout police and court proceedings.

Consultation and Training

A series of lectures and workshops for community groups and professionals that help to increase awareness and understanding of victimization issues and crisis intervention.

Information and Referral

Coordination and communication among physical and mental healthcare practitioners, social service agencies and the criminal justice system.

It’s Your Call

The main goal of the Victim Intervention Program is to help individuals and their loved ones reclaim a sense of health and well-being in the aftermath of a crisis. If you or someone you know is the victim of a crime, please call the appropriate number listed below.

VIP WEBSITE

Contact Numbers

Resource Phone number
Police Emergencies 911
Police Dispatcher (615) 862-8600
Sex Crimes Section (615) 862-7540
Youth Services Division (615) 862-7417
Domestic Violence Division (615) 880-3000
Domestic Violence Counselors (615) 880-3000
Victim Intervention Program (615) 862-7773
District Attorney’s Office (615) 862-5500
Victim Witness Services (615) 862-5500
TN Criminal Injury Compensation Program (615) 741-2734

Additional Resources

Medicare / Medicaid Legal Services Tennessee

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OUR LEGACY
Ashley’s Voice Outreach Advocate Group

mjgb96

For 20 years, the Tennessee Justice Center (TJC) has been standing with vulnerable Tennessee families and helping them access basic necessities of life. After Congress placed restrictions on legal services programs, community and bar leaders from all parts of our state, and from every part of the political spectrum, came together to form TJC. Without their leadership, our clients for the last 20 years would have had nowhere to turn.

FROM THE BEGINNING

 

TJC uses the law, education, and advocacy to fight red tape and ensure our neighbors have the necessities they need to thrive. TJC makes a strategic and outsized positive impact on the state: millions of Tennesseans have benefited from TJC’s work. Every $1 donated to TJC generated $295 in essential services like health care and nutrition for vulnerable Tennesseans in 2015-2016.

Serving Clients

TJC’s work is rooted in the experience of individual Tennesseans whom we serve as clients – children with disabilities whose HMOs deny health care their doctors ordered, seniors needing long-term care at home to avoid institutionalization, families who wrongly lose their insurance coverage, mothers who need prenatal care, and many more. The real experiences of these hard-working, courageous Tennesseans struggling with red tape inspire us and drive our work. We are so grateful to be a part of their stories. Watch the video below to hear 20 years of TJC voices, and consider a donation to help our life-saving work continue for more families like these. 

Leveraging Knowledge

TJC builds capacity in the community and makes its limited resources have a larger impact by partnering with hundreds of agencies and individuals around the state. People who serve or intersect with our clients rely on TJC’s knowledge, training, and resources in best helping their constituents. Medical staff, social workers, religious and community leaders, other nonprofits, juvenile court workers, and many more attend TJC’s trainings, use our resources, and refer clients to us. In 2016, 36,712 Tennesseans gained health care through community partners who were trained and supported by TJC.

Moving Systems

TJC uses the insights from clients and community partners to identify and address policy or system problems. TJC has built relationships with state and federal agencies, elected officials, and other policymakers to educate them about issues that impact our neighbors, and are frequently consulted by state and national lawmakers when legislation is proposed that affects public benefits programs. Perhaps more importantly, TJC empowers community members to understand issues that affect them and work with elected officials to resolve them. Most recently, TJC has joined hundreds of community leaders and partner organizations around the state in efforts to close the coverage gap and expand health insurance to all Tennesseans who need it.

TJC also uses the law to hold government accountable for its most vulnerable people. Selected successes include:

  • Wilson v Gordon, which allows Tennesseans whose TennCare health insurance applications are delayed (some for many months) the right to appeal.
  • Binta B v Gordon (formerly Grier v Goetz), which secured appeal rights for individuals whose TennCare HMOs denied services ordered by their doctors.
  • John B v Emkes, which improved health care for over 750,000 Tennessee children by ensuring they had access to all medically necessary services ordered by their doctor.
  • Rosen v Goetz, which ensured that Tennesseans were granted notice and appeal rights when the State sought to terminate their TennCare eligibility.
  • Newberry v Goetz, which ensured people with disabilities and seniors have access to comparable services at home rather than a nursing home.

TJC has achieved these results with very limited resources through the strength of its partnerships.  Monumental pro bono support that has been offered by interns, volunteers, individual attorneys, and private firms across Tennessee and the nation. We join our clients, partners, and ordinary, hard-working Tennesseans in fighting for fairness and justice for all.

Year End Letters

At the end of every year, TJC sends out letters to update our supporters of the progress that we have made in the past 12 months. The letters show the process of our growth, and here you can see the letters we’ve sent out since 2000.

Whats Cookin Nashville Gold Line

Ashely’s Voice
615-673-1112
Info@AshleysVoice.com 

Cyclic Vomiting Syndrome – Nashville TN

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March 21, 2017

Cyclic Vomiting Syndrome – Tennessee
CVS – Treatment

As of this date there are no Physicians in Tennessee that specialize in the treatment of

Cyclic Vomiting Syndrome  ( CVS ). We are a none profit organization and we do offer free

resource information about CVS. Please contact us TODAY at 615-673-2221.

There is hope and a growing awareness of this cruel condition.

Dan Zellars
CVS Tennessee – Ashley’s Voice Outreach Resource Group

Cyclic Vomiting Syndrome Organizations Worldwide Join Forces to Educate and Promote Awareness

Information contained on this page is provided by an independent third-party content provider. Frankly and this Site make no warranties or representations in connection therewith. If you are affiliated with this page and would like it removed please contact pressreleases@franklyinc.com

SOURCE CVSA

Social media, newspapers, radio and TV stations can help spread the word about this complicated illness

More than 25 Countries will participate

MILWAUKEE, March 1, 2017 /PRNewswire/ — On March 5, 2017, CVSA USA/Canada will be joining forces with CVSA Organizations throughout the world to promote awareness of Cyclic Vomiting Syndrome (CVS).  CVS is a debilitating condition characterized by episodes of severe nausea and persistent vomiting, interspersed with periods of wellness.  Estimates show CVS affects about 2 percent of school-aged children.  Many of these children are misdiagnosed, and many adults are undiagnosed or wrongly diagnosed as having eating disorders.  Treatment often requires hospitalization, IV fluids, a number of medications, and sedation.  At it’s worst the disease can result in serious complications like tearing of the esophagus and even death.  CVS affects people young and old, all over the world.  CVS often prevents individuals and their families from enjoying normal lives.

Canada, Denmark, Germany, Ireland, Italy, Japan, the Netherlands, Spain, United Kingdom, and the USA along with more than 20 other countries are joining together to make sure that there’s a global, cohesive effort to make sure this condition is understood.  By working together with a cohesive, worldwide message we can make sure people know this a more common syndrome than they might think.  By sharing information and resources with one another we can reach both sufferers and those who still may be undiagnosed.

The Starfish Story

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The Starfish Story: one step towards changing the world

You may have heard this one, but I find that it doesn’t hurt to be reminded of it every once in a while.  First let me tell you the story, and then we can talk about it.

Once upon a time, there was an old man who used to go to the ocean to do his writing. He had a habit of walking on the beach every morning before he began his work. Early one morning, he was walking along the shore after a big storm had passed and found the vast beach littered with starfish as far as the eye could see, stretching in both directions.

Off in the distance, the old man noticed a small boy approaching.  As the boy walked, he paused every so often and as he grew closer, the man could see that he was occasionally bending down to pick up an object and throw it into the sea.  The boy came closer still and the man called out, “Good morning!  May I ask what it is that you are doing?”

The young boy paused, looked up, and replied “Throwing starfish into the ocean. The tide has washed them up onto the beach and they can’t return to the sea by themselves,” the youth replied. “When the sun gets high, they will die, unless I throw them back into the water.”

The old man replied, “But there must be tens of thousands of starfish on this beach. I’m afraid you won’t really be able to make much of a difference.”

The boy bent down, picked up yet another starfish and threw it as far as he could into the ocean. Then he turned, smiled and said, “It made a difference to that one!”

adapted from The Star Thrower, by Loren Eiseley (1907 – 1977)
We all have the opportunity to help create positive change, but if you’re like me, you sometimes find yourself thinking, “I’m already really busy, and how much of a difference can I really make?”  I think this is especially true when we’re talking about addressing massive social problems like tackling world hunger or finding a cure for cancer, but it pops up all of the time in our everyday lives, as well. So when I catch myself thinking that way, it helps to remember this story.  You might not be able to change the entire world, but at least you can change a small part of it, for someone.

They say that one of the most common reasons we procrastinate is because we see the challenge before us as overwhelming, and that a good way to counter that is to break the big challenge down into smaller pieces and then take those one at a time–like one starfish at a time.  And to that one starfish, it can make a world of difference.

 

“A single, ordinary person still can make a difference – and single, ordinary people are doing precisely that every day.”
Chris Bohjalian, Vermont-based author and speaker

Phenergan Side Effects

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For the Consumer

Applies to promethazine: oral elixir, oral syrup, oral tablet

Note: This page contains side effects data for the generic drug promethazine. It is possible that some of the dosage forms included below may not apply to the brand name Phenergan.

How does Phenergan work?
It blocks the effects of the naturally occurring chemical histamine in your body. Phenergan is used to treat allergy symptoms such as itching, runny nose, sneezing, itchy or watery eyes, hives, and itchy skin rashes. Phenergan also prevents motion sickness, and treats nausea and vomiting or pain after surgery.

Other dosage forms:

As well as its needed effects, promethazine (the active ingredient contained in Phenergan) may cause unwanted side effects that require medical attention.

Stop taking promethazine and get emergency help immediately if any of the following effects occur:

RareSymptoms of neuroleptic malignant syndrome; two or more occur together; most of these effects do not require emergency medical attention if they occur alone

  • Convulsions (seizures)
  • difficult or unusually fast breathing
  • fast heartbeat or irregular pulse
  • high fever
  • high or low (irregular) blood pressure
  • increased sweating
  • loss of bladder control
  • severe muscle stiffness
  • unusually pale skin
  • unusual tiredness or weakness

Major Side Effects

If any of the following side effects occur while taking promethazine, check with your doctor immediately:

Incidence not known:

  • Abdominal or stomach pain
  • black, tarry stools
  • bleeding gums
  • blood in urine or stools
  • bloody nose
  • blurred vision
  • chest pain or discomfort
  • chills
  • clay-colored stools
  • confusion as to time, place, or person
  • cough or hoarseness
  • dark urine
  • decreased awareness or responsiveness
  • difficulty or troubled breathing
  • double vision
  • fast, pounding, or irregular heartbeat or pulse
  • fever with or without chills
  • fixed position of eye
  • headache
  • heavier menstrual periods
  • high fever
  • holding false beliefs that cannot be changed by fact
  • hyperexcitability
  • increased or decreased blood pressure
  • increased sweating
  • irregular, fast or slow, or shallow breathing
  • itching
  • large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lightheadedness, dizziness, or fainting
  • loss of appetite
  • loss of bladder control
  • lower back or side pain
  • mimicry of speech or movements
  • mutism
  • nasal stuffiness
  • nausea
  • negativism
  • nightmares
  • noisy breathing
  • not breathing
  • painful or difficult urination
  • pale or blue lips, fingernails, or skin
  • peculiar postures or movements, mannerisms or grimacing
  • pinpoint red spots on skin
  • seeing double
  • seeing, hearing, or feeling things that are not there
  • seizures
  • severe muscle stiffness
  • severe sleepiness
  • shortness of breath
  • skin rash
  • slow or irregular heartbeat
  • sore throat
  • sores, ulcers, or white spots on lips or in mouth
  • sticking out of tongue
  • swollen glands
  • tightness in chest
  • tremors
  • uncontrolled twisting movements of neck
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual excitement, nervousness, or restlessness
  • unusual tiredness or weakness
  • vomiting of blood
  • wheezing
  • yellow eyes or skin

Symptoms of overdose:

  • Discouragement
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • dry mouth
  • excessive muscle tone
  • feeling of warmth
  • feeling sad or empty
  • irritability
  • lack of appetite
  • loss of interest or pleasure
  • muscle tension or tightness
  • overactive reflexes
  • pupils of eyes large and not moving or responding to light
  • redness of the face, neck, arms and occasionally, upper chest
  • shakiness and unsteady walk
  • sudden death
  • trouble concentrating
  • trouble sleeping
  • unconsciousness
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • unusual paleness

Minor Side Effects

Some promethazine side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:

Incidence not known:

  • blistering, crusting, irritation, itching, or reddening of skin
  • continuing ringing or buzzing or other unexplained noise in ears
  • cracked, dry, scaly skin
  • dizziness
  • drowsiness
  • excitation
  • false or unusual sense of well-being
  • hearing loss
  • hives or welts
  • increased sensitivity of skin to sunlight
  • lack of coordination
  • loss of strength or energy
  • muscle pain or weakness
  • redness or other discoloration of skin
  • relaxed and calm
  • sunburn
  • swelling
  • unable to sleep
  • vomiting

For Healthcare Professionals

Applies to promethazine: compounding powder, injectable solution, oral syrup, oral tablet, rectal suppository

Nervous system

Nervous system side effects have been reported the most frequently. These have included excessive sedation, drowsiness, fatigue, paradoxical excitation, confusion, disorientation, tremors, convulsive seizures, and decreased motor coordination. Extrapyramidal effects (including oculogyric crises, torticollis and tongue protrusion), encephalitic symptoms, convulsions, and psychosis have been rarely reported.[Ref]

Other

Neuroleptic malignant syndrome has been rarely observed during treatment with promethazine (the active ingredient contained in Phenergan) It usually occurs within the first 30 days after exposure to neuroleptics.[Ref]

Fever, altered consciousness, labile blood pressure, autonomic dysfunction, and muscle rigidity are the hallmarks of the neuroleptic malignant syndrome. The neuroleptic malignant syndrome is associated with a case fatality rate ranging from 5% to 20%. Immediate discontinuation of promethazine and intensive monitoring and supportive care are indicated.[Ref]

Local

Local side effects have been associated with the inadvertent intraarterial injection of promethazine (the active ingredient contained in Phenergan) which carries a high risk of distal necrosis and frequently requires amputation of the affected limb. Subcutaneous injection has more rarely caused chemical irritation and necrosis.[Ref]

Respiratory

Respiratory side effects have rarely included respiratory depression and arrest, especially with parenteral administration of promethazine (the active ingredient contained in Phenergan) Equipment for resuscitation should be available when parenteral promethazine is used. Asthma and nasal stuffiness have also been reported.[Ref]

Gastrointestinal

Gastrointestinal side effects have included nausea, vomiting, and dry mouth.[Ref]

Hypersensitivity

Hypersensitivity side effects have included rare reports of rash, pruritus, hypotension, photosensitivity, and tachycardia.[Ref]

Hematologic

Hematologic side effects have included rare cases of neutropenia. Leukopenia, thrombocytopenia, thrombocytopenic purpura, and agranulocytosis have also been reported.[Ref]

Cardiovascular

Cardiovascular side effects have rarely included tachycardia, bradycardia, and increased or decreased blood pressure. Prolongation of the QT interval, heart block, and malignant arrhythmias have been reported in association with other phenothiazines.[Ref]

Immunologic

Immunologic side effects have included rare reports of a systemic lupus erythematosus syndrome.[Ref]

Hepatic

Hepatic side effects have included jaundice.[Ref]

Dermatologic

Dermatologic side effects have included dermatitis, photosensitivity, and urticaria.[Ref]

Psychiatric

Psychiatric side effects have included hallucinations. Other paradoxical reactions following a single dose have included nightmares, delirium and agitated behavior.[Ref]

References

1. McAllister CJ, Scowden EB, Stone WJ “Toxic psychosis induced by phenothiazine administration in patients with chronic renal failure.” Clin Nephrol 10 (1978): 191-5

2. Fisher SE “Encephalitic reaction to promethazine.” J Pediatr 80 (1972): 896-7

3. Nahata MC, Clotz MA, Krogg EA “Adverse effects of meperidine, promethazine, and chlorpromazine for sedation in pediatric patients.” Clin Pediatr (Phila) 24 (1985): 558-60

4. Kahn A, Hasaerts D, Blum D “Phenothiazine-induced sleep apneas in normal infants.” Pediatrics 75 (1985): 844-7

5. “Product Information. Promethazine Hydrochloride (promethazine).” ESI Lederle Generics, Philadelphia, PA.

6. Wood CD, Manno JE, Manno BR, Redetzki HM, Wood M, Vekovius WA “Side effects of antimotion sickness drugs.” Aviat Space Environ Med 55 (1984): 113-6

7. Schwinghammer TL, Kroboth FJ, Juhl RP “Extrapyramidal reaction secondary to oral promethazine.” Clin Pharm 3 (1984): 83-5

8. Waterhouse RG “Epileptiform convulsions in children following premedication with Pamergan SP100.” Br J Anaesth 39 (1967): 268-70

9. Nicholson AN “Central effects of H1 and H2 antihistamines.” Aviat Space Environ Med 56 (1985): 293-8

10. Tenenbein M “The neuroleptic malignant syndrome: occurrence in a 15-year-old boy and recovery with bromocriptine therapy.” Pediatr Neurosci 12 (1985): 161-4

11. ChanTack KM “Neuroleptic malignant syndrome due to promethazine.” South Med J 92 (1999): 1017-8

12. Hager DL, Wilson JN “Gangrene of the hand following intra-arterial injection.” Arch Surg 94 (1967): 86-9

13. Mostafavi H, Samimi M “Accidental intra-arterial injection of promethazine HCl during general anesthesia: report of a case.” Anesthesiology 35 (1971): 645-6

14. Mills PJ “Anaphylactoid reaction to oral premedication with temazepam and promethazine .” Anaesthesia 43 (1988): 66

15. “Product Information. Phenergan (promethazine).” Wyeth-Ayerst Laboratories, Philadelphia, PA.

16. Fabius AJ, Gaulhofer WK “Systemic lupus erythematosus induced by psychotropic drugs.” Acta Rheumatol Scand 17 (1971): 137-47

It is possible that some side effects of Phenergan may not have been reported. These can be reported to the FDA here. Always consult a healthcare professional for medical advice.