Droperidol: Difference between revisions
(Created page with "==Administration== *Type: antipsychotic *Dosage Forms: *Routes of Administration: *Common Trade Names: ==Adult Dosing== ===Combative patient=== *10mg IM ==Pediatric...") |
|||
| (12 intermediate revisions by 5 users not shown) | |||
| Line 1: | Line 1: | ||
==Administration== | ==Administration== | ||
*Type: [[antipsychotic]] | *Type: [[antipsychotic]], [[antiemetics]] | ||
*Dosage Forms: | *Dosage Forms: 5mg/2mL | ||
*Routes of Administration: | *Routes of Administration: IV/IM | ||
*Common Trade Names: | *Common Trade Names: Inapsine | ||
==Adult Dosing== | ==Adult Dosing== | ||
===[[Combative patient]]=== | ===[[Combative patient]]=== | ||
*5-10mg IV | |||
*10mg IM | *10mg IM | ||
===[[Nausea/vomiting]]=== | |||
*0.625-2.5mg IV | |||
===[[Headache]]=== | |||
*2.5mg IV or 2.5-5mg IM | |||
===Pain (with or without opiate tolerance)=== | |||
*0.625-5mg or higher IV/IM<ref>Richards JR, Richards IN, Ozery G, Derlet RW. Droperidol analgesia for opioid-tolerant patients. J Emerg Med. 2011 Oct;41(4):389-96. doi: 10.1016/j.jemermed.2010.07.005. Epub 2010 Sep 15. PMID: 20832967.</ref><ref>Miller AC, Khan AM, Castro Bigalli AA, Sewell KA, King AR, Ghadermarzi S, Mao Y, Zehtabchi S. Neuroleptanalgesia for acute abdominal pain: a systematic review. J Pain Res. 2019;12:787-801 https://doi.org/10.2147/JPR.S187798</ref> | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===[[Nausea and vomiting (peds)|Nausea/vomiting]]=== | |||
*2-12yo: 0.015-0.1mg/kg IV/IM | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug pregnancy categories|Pregnancy Rating]]: | *[[Drug pregnancy categories|Pregnancy Rating]]: C | ||
*Lactation risk: | *Lactation risk: Infant risk cannot be ruled out | ||
*Renal dosing: Administer with caution | |||
*Hepatic dosing: Administer with caution | |||
* | |||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Known or suspected prolonged QT | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*[[Prolonged QT]], [[torsades]], [[ventricular tachycardia]], [[cardiac arrest]] | |||
**''Note: effect on QT interval is dose-dependent'' | |||
**In 2001, FDA gave black box warning for risk of [[torsades de pointes]], however there was little evidence to support this | |||
**Large cohort of patients in ED showed safety of its administration<ref>Gaw CM, Cabrera D, Bellolio F, Mattson AE, Lohse CM, Jeffery MM. Effectiveness and safety of droperidol in a United States emergency department. Am J Emerg Med. 2020;38(7):1310-1314. doi:10.1016/j.ajem.2019.09.007</ref> | |||
*[[Neuroleptic malignant syndrome]] | |||
*[[Anaphylaxis]] | |||
===Common=== | ===Common=== | ||
*Somnolence, dysphoria, anxiety | |||
*[[Akathisia]] | |||
*Hypotension | |||
*Tachycardia | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 123-147m (adults), 75-127m (children) | ||
*Metabolism: | *Metabolism: hepatic | ||
*Excretion: | *Excretion: mostly renal | ||
==Mechanism of Action== | ==Mechanism of Action== | ||
*Dopamine (D2) antagonist. Some serotonergic, histaminergic, and α-adrenergic effect | |||
==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Antipsychotics]] | |||
*[[Combative patient]] | |||
==External Links== | |||
*[http://www.emdocs.net/droperidol-use-in-the-emergency-department-whats-old-is-new-again/ emDOCs: Droperidol Use in the Emergency Department – What’s Old is New Again] | |||
*[https://www.acep.org/painmanagement/newsroom/may2020/oldie-but-a-goodie-10-pearls-of-droperidol/ ACEP: Oldie but a Goodie: 10 Pearls of Droperidol] | |||
==References== | ==References== | ||
Latest revision as of 17:01, 6 October 2021
Administration
- Type: antipsychotic, antiemetics
- Dosage Forms: 5mg/2mL
- Routes of Administration: IV/IM
- Common Trade Names: Inapsine
Adult Dosing
Combative patient
- 5-10mg IV
- 10mg IM
Nausea/vomiting
- 0.625-2.5mg IV
Headache
- 2.5mg IV or 2.5-5mg IM
Pain (with or without opiate tolerance)
Pediatric Dosing
Nausea/vomiting
- 2-12yo: 0.015-0.1mg/kg IV/IM
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
- Renal dosing: Administer with caution
- Hepatic dosing: Administer with caution
Contraindications
- Allergy to class/drug
- Known or suspected prolonged QT
Adverse Reactions
Serious
- Prolonged QT, torsades, ventricular tachycardia, cardiac arrest
- Note: effect on QT interval is dose-dependent
- In 2001, FDA gave black box warning for risk of torsades de pointes, however there was little evidence to support this
- Large cohort of patients in ED showed safety of its administration[3]
- Neuroleptic malignant syndrome
- Anaphylaxis
Common
- Somnolence, dysphoria, anxiety
- Akathisia
- Hypotension
- Tachycardia
Pharmacology
- Half-life: 123-147m (adults), 75-127m (children)
- Metabolism: hepatic
- Excretion: mostly renal
Mechanism of Action
- Dopamine (D2) antagonist. Some serotonergic, histaminergic, and α-adrenergic effect
Comments
See Also
External Links
- emDOCs: Droperidol Use in the Emergency Department – What’s Old is New Again
- ACEP: Oldie but a Goodie: 10 Pearls of Droperidol
References
- ↑ Richards JR, Richards IN, Ozery G, Derlet RW. Droperidol analgesia for opioid-tolerant patients. J Emerg Med. 2011 Oct;41(4):389-96. doi: 10.1016/j.jemermed.2010.07.005. Epub 2010 Sep 15. PMID: 20832967.
- ↑ Miller AC, Khan AM, Castro Bigalli AA, Sewell KA, King AR, Ghadermarzi S, Mao Y, Zehtabchi S. Neuroleptanalgesia for acute abdominal pain: a systematic review. J Pain Res. 2019;12:787-801 https://doi.org/10.2147/JPR.S187798
- ↑ Gaw CM, Cabrera D, Bellolio F, Mattson AE, Lohse CM, Jeffery MM. Effectiveness and safety of droperidol in a United States emergency department. Am J Emerg Med. 2020;38(7):1310-1314. doi:10.1016/j.ajem.2019.09.007