Droperidol: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: [[antipsychotic]], [[antiemetics]] | *Type: [[antipsychotic]], [[antiemetics]] | ||
*Dosage Forms: | *Dosage Forms: 5mg/2mL | ||
*Routes of Administration: IV/IM | *Routes of Administration: IV/IM | ||
*Common Trade Names: | *Common Trade Names: Inapsine | ||
==Adult Dosing== | ==Adult Dosing== | ||
| Line 9: | Line 9: | ||
*5-10mg IV | *5-10mg IV | ||
*10mg IM | *10mg IM | ||
===[[Nausea/vomiting]]=== | |||
*0.625-2.5mg IV | |||
===[[Headache]]=== | ===[[Headache]]=== | ||
*2.5mg IV or 2.5-5mg IM | *2.5mg IV or 2.5-5mg IM | ||
=== | ===Pain (with or without opiate tolerance)=== | ||
*0.625- | *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/vomiting]]=== | ===[[Nausea and vomiting (peds)|Nausea/vomiting]]=== | ||
*2-12yo: 0.015-0.1mg/kg IV/IM | *2-12yo: 0.015-0.1mg/kg IV/IM | ||
| Line 31: | Line 32: | ||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Prolonged QT, torsades, ventricular tachycardia, cardiac arrest | *[[Prolonged QT]], [[torsades]], [[ventricular tachycardia]], [[cardiac arrest]] | ||
**''Note: effect on QT interval is dose-dependent'' | **''Note: effect on QT interval is dose-dependent'' | ||
*Neuroleptic malignant syndrome | **In 2001, FDA gave black box warning for risk of [[torsades de pointes]], however there was little evidence to support this | ||
*Anaphylaxis | **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 | *Somnolence, dysphoria, anxiety | ||
* | *[[Akathisia]] | ||
*Hypotension | *Hypotension | ||
*Tachycardia | *Tachycardia | ||
| Line 50: | Line 54: | ||
==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Antipsychotics]] | *[[Antipsychotics]] | ||
*[[Combative patient]] | *[[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