The drug promethazine has a rather impressive list of side effects:
Sensory organs and nervous system. In the form of dizziness; visual acuity is impaired; development of sedation; in the form of visual and accommodation disorders; manifestation of drowsiness; in the form of nystagmus; manifestation of agitation; occurrence of tinnitus or ringing in the ears; pronounced anxiety; development of extrapyramidal disorders; nightmares; as agitation of psychomotor nature; as disorientation; manifestation of hysteria; pronounced fatigue; in the form of an oculogyric crisis; onset of lethargy; as catatonic status; pronounced motor coordination disorders; onset of insomnia; feeling of pain in the head; development of euphoria; more frequent manifestation of nighttime apnea; state of nervousness; as confusion; appearance of convulsions; increased activity of convulsive nature.
Blood and cardiovascular system. Hypertension; thrombocytopenic purpura; orthostatic hypotension; aplastic anemia; bradycardia; agranulucitosis; tachycardia; leukopenia; palpitation; thrombocytopenia; arrhythmia; fainting.
Digestive system. Patients complained of a sensation of dryness and numbness in the mouth. Cases of nausea up to and including the development of vomiting have also been reported. Some suffered from constipation/ diarrhea. Cases of jaundice and cholestasis have also been reported.
Respiratory system. There were cases of irregular breathing in patients, in addition to complaints of dryness in the nasal cavity and pharynx.
Urogenital system. Delayed as well as painful and difficult urination was observed.
Allergies. Patients were found to have dermatitis, exanthema, asthma and urticaria. There have been cases of angioedema and the development of anaphylaxis reactions.
Other. Possible phenomenon of photosybilization. Soreness and infiltration at injection sites and increased sweating have also been reported.
Signs of drug overdose include the following symptoms: In the form of shortness of breath; respiratory depression; hyperemia of the facial skin; loss of consciousness; feeling of dry mucous membranes; development of hypotension; anxiety; tremors; dilation of the pupil; development of epileptiform seizures; manifestation of motor hyperactivity; development of extrapyramidal disorders; pronounced agitation; impairment of attention, sleep, memory (mainly in children).
If intoxication is caused by ingestion of promethazine, first of all vomiting should be induced for therapeutic purposes and then the victim should be gastric lavage. Activated charcoal and saline type laxatives should be administered. Intravenous fluids and support of important vital functions are provided. Symptomatic therapy includes: giving oxygen, vasoconstrictor preparations if hypotension occurs. Anticholinergics, diphenhydramine and barbiturates will be needed if extrapyramidal disorders develop. The administration of dialysis is not effective. Administration of epinephrine and analeptics is not recommended as it may increase the symptoms of hypotension and development of seizures.