Droperidol: Difference between revisions

Revision as of 16:58, 6 October 2021

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

Dopamine (D2) antagonist. Some serotonergic, histaminergic, and α-adrenergic effect

↑ 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

Authors:

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 ===Common===
 *Somnolence, dysphoria, anxiety
-*'''Akathisia''': restlessness, inability to sit still, distressing disquiet
+*[[Akathisia]]
-**Treatable with diphenhydramine (50mg PO/IM/IV) OR benztropine (1-2mg IV) and others<ref>Pringsheim T, Gardner D, Addington D, et al. The Assessment and Treatment of Antipsychotic-Induced Akathisia. Can J Psychiatry. 2018;63(11):719-729. doi:10.1177/0706743718760288</ref><ref>Rice, J. CoreEM.net - Akathisia. https://coreem.net/core/akathisia/ Accessed: Oct 4, 2021.</ref>
 *Hypotension
 *Tachycardia
@@ Line 55: / Line 54: @@
 ==Comments==
-In my experience akathisia and dystonia are more common in women up to about 30 years old and teenagers of both sexes. I don't use it on anyone younger than 18. Also, there seems to be an association with rate of administration and side-effects. When I order it, I have the nurses put the dose in a 10mL saline flush and give it over a minute. Anecdotally, this seems to decrease the rate of side-effects. When they occur, 50 mg diphenhydramine IVP is my go-to medication, which usually works, though I have had to redose.
-It is VERY useful as an adjunct to other pain medications, opiates or otherwise, when you are reaching your comfort level for those meds.
-It is far superior to ondansetron for intractable vomiting, especially cannabinoid hyperemesis syndrome, which some readers will use droperidol's sister drug, haloperidol, to treat.
 ==See Also==