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Dr. Bob is Robert Hsiung, MD,
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Posted by jerryTRD on November 7, 2010, at 20:43:11
Metoclopramide (Reglan) is used to help with gastric motility and nausea. Promethazine (Phenergan) is an old antihistamine that is used for nausea and vomiting and sedation. But what I noticed about both is that they both antagonize dopamine receptors and carry warnings of EPS & Tardive Dyskinesia.
For you self-taught pharmacologists out there - are these two meds old cousins of antipsychotics?
Just curious
Jerry
Posted by Christ_empowered on November 8, 2010, at 0:22:11
In reply to Metoclopramide + Promethazine - antipsychotics?, posted by jerryTRD on November 7, 2010, at 20:43:11
I think they're both phenothiazines (same family that gave us Thorazine, stelazine, etc.).
Promethazine was used for less severe cases of "schizophrenia" back in the day. (I'm using the "" b/c "schizophrenia," particularly in the US back in the 50s-70s, was kind of a catch-all term for mental problems). I seem to recall an ad showing Promethazine and prochlorperazine (compazine) being more for "ambulatory" schizophrenia, high-dose Thorazine more for the hospitalized cases...something like that, anyways.
Since its a neuroleptic phenothiazine, promethazine can cause TD. I think part of the TD risk if from the anti-dopamine action and part is from oxidative stress...the phenothiazines are pretty toxic, if I recall correctly, so that may be why TD rates are relatively high when they're used long-term.
Posted by Phillipa on November 8, 2010, at 10:03:23
In reply to Re: Metoclopramide + Promethazine - antipsychotics?, posted by Christ_empowered on November 8, 2010, at 0:22:11
If basically sort of antipsychotics how do they stop vomiting? As given quite a bit for post op vomiting. I used a suppository when vomiting after a surgery. So basically it was an antipsychotic? Didn't know that. And all that I gave when nursing you would think this would be part of curriculum in school. Hopefully more pharmacology is required today. Phillipa
Posted by ed_uk2010 on November 8, 2010, at 13:36:48
In reply to Metoclopramide + Promethazine - antipsychotics?, posted by jerryTRD on November 7, 2010, at 20:43:11
>For you self-taught pharmacologists out there - are these two meds old cousins of antipsychotics?
Promethazine is a phenothiazine. It is related to chlorpromazine. Its dopamine blocking action is considerably weaker than chlorpromazine and its antipsychotic activity is minimal. There are very few reports of TD with promethazine.
Metoclopramide is a benzamide. It is structurally very different to the phenothiazines, and is more similar to sulpiride and amisulpride. Although metoclopramide can cause EPS, it is not believed to be an effective antipsychotic.
This is the end of the thread.
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