Abstract：
UNASSIGNED: Promethazine is a phenothiazine derivative that possesses antihistamine, anti-dopaminergic and anticholinergic properties. It is commonly used to treat motion sickness, allergic conditions, nausea and vomiting, in addition to its use as a sedative. Promethazine has vesicant properties and is highly caustic to the intima of blood vessels and surrounding tissues. Intravenous administration may result in thrombophlebitis, unintentional intra-arterial administration, perivascular extravasation and tissue necrosis. To the best of our knowledge there is no previous published report of promethazine-induced thrombophlebitis from sub- Saharan Africa.
UNASSIGNED: A 29-year-old Nigerian male was admitted at our hospital on account of malaria with acute gastroenteritis. Due to persistent vomiting, he was administered 25 mg of promethazine injection via a size 22G intravenous cannula which was inserted the previous day on the anteromedial aspect of his right forearm and maintained with continuous intravenous crystalloid infusion. Upon administration of promethazine, he experienced intense burning and erythema. The cannula was removed immediately, another cannula was inserted on the contralateral arm, and promethazine was replaced with ondansetron. Subsequently, he developed a tender, subcutaneous cord-like swelling extending from the middle-third of the anteromedial aspect of his right forearm, corresponding with the site of previous venous cannulation. Ultrasonography revealed a hypoechoic, non-compressible basilic vein, with no flow on colour Doppler interrogation, in keeping with superficial thrombophlebitis. He was treated with a topical anti-inflammatory agent, and the pain and redness subsided after four weeks.
UNASSIGNED: The preferred parenteral route of administration of promethazine is deep intramuscular injection. Recommendations to prevent promethazine-induced thrombophlebitis include: use of large and patent veins, use of lower doses, drug dilution and slow administration, use of alternative therapies, and patient education. Promethazine-induced tissue injury is under-reported in this part of the world. Creating awareness through this case report would help reduce the morbidity following promethazine administration.
UNASSIGNED: A 29-year-old Nigerian male was admitted at our hospital on account of malaria with acute gastroenteritis. Due to persistent vomiting, he was administered 25 mg of promethazine injection via a size 22G intravenous cannula which was inserted the previous day on the anteromedial aspect of his right forearm and maintained with continuous intravenous crystalloid infusion. Upon administration of promethazine, he experienced intense burning and erythema. The cannula was removed immediately, another cannula was inserted on the contralateral arm, and promethazine was replaced with ondansetron. Subsequently, he developed a tender, subcutaneous cord-like swelling extending from the middle-third of the anteromedial aspect of his right forearm, corresponding with the site of previous venous cannulation. Ultrasonography revealed a hypoechoic, non-compressible basilic vein, with no flow on colour Doppler interrogation, in keeping with superficial thrombophlebitis. He was treated with a topical anti-inflammatory agent, and the pain and redness subsided after four weeks.
UNASSIGNED: The preferred parenteral route of administration of promethazine is deep intramuscular injection. Recommendations to prevent promethazine-induced thrombophlebitis include: use of large and patent veins, use of lower doses, drug dilution and slow administration, use of alternative therapies, and patient education. Promethazine-induced tissue injury is under-reported in this part of the world. Creating awareness through this case report would help reduce the morbidity following promethazine administration.
摘要：
■异丙嗪是一种具有抗组胺药的噻嗪衍生物，抗多巴胺能和抗胆碱能特性。它通常用于治疗晕车，过敏状况,恶心和呕吐，除了用作镇静剂。异丙嗪具有起泡特性，对血管内膜和周围组织具有高度腐蚀性。静脉给药可能导致血栓性静脉炎，无意的动脉内给药，血管周围外渗和组织坏死。据我们所知，以前没有关于撒哈拉以南非洲异丙嗪引起的血栓性静脉炎的报道。
一名29岁的尼日利亚男性因疟疾合并急性胃肠炎入院。由于持续呕吐,他通过22G大小的静脉内插管给予25mg异丙嗪注射液，该插管在前一天插入右前臂的前内侧，并通过连续静脉内晶体输注维持。服用异丙嗪后，他经历了强烈的烧伤和红斑。立即拔除套管,另一根套管插入对侧手臂，用昂丹司琼代替异丙嗪。随后，他开发了一个招标，皮下脐带样肿胀从他的右前臂前内侧的三分之一处延伸，与先前静脉插管的位置相对应。超声检查显示低回声，不可压缩的贵宾静脉，彩色多普勒询问没有流量，与浅表血栓性静脉炎保持一致。他接受了局部抗炎药治疗，四周后疼痛和红肿消退。
■异丙嗪的优选肠胃外给药途径是深度肌内注射。预防异丙嗪引起的血栓性静脉炎的建议包括：使用大静脉和静脉通畅，使用较低的剂量，药物稀释和缓慢给药，使用替代疗法，和病人的教育。异丙嗪诱导的组织损伤在该地区的报道不足。通过此病例报告提高意识将有助于降低异丙嗪给药后的发病率。
一名29岁的尼日利亚男性因疟疾合并急性胃肠炎入院。由于持续呕吐,他通过22G大小的静脉内插管给予25mg异丙嗪注射液，该插管在前一天插入右前臂的前内侧，并通过连续静脉内晶体输注维持。服用异丙嗪后，他经历了强烈的烧伤和红斑。立即拔除套管,另一根套管插入对侧手臂，用昂丹司琼代替异丙嗪。随后，他开发了一个招标，皮下脐带样肿胀从他的右前臂前内侧的三分之一处延伸，与先前静脉插管的位置相对应。超声检查显示低回声，不可压缩的贵宾静脉，彩色多普勒询问没有流量，与浅表血栓性静脉炎保持一致。他接受了局部抗炎药治疗，四周后疼痛和红肿消退。
■异丙嗪的优选肠胃外给药途径是深度肌内注射。预防异丙嗪引起的血栓性静脉炎的建议包括：使用大静脉和静脉通畅，使用较低的剂量，药物稀释和缓慢给药，使用替代疗法，和病人的教育。异丙嗪诱导的组织损伤在该地区的报道不足。通过此病例报告提高意识将有助于降低异丙嗪给药后的发病率。
