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droperidol

droperidol (Droleptan)

introduction

  • droperidol is a butyrophenone type antipsychotic agent which is similar to haloperidol
  • it produces marked tranquillization and sedation as well as having an anti-emetic effect
  • it potentiates other CNS depressants
  • also produces mild alpha-adrenergic blockade, peripheral vascular dilatation, hypotension, and reduction of the pressor effect of adrenaline
  • as with all drugs, benefits of using droperidol should be weighed against the potential risk

C/I

precautions

  • FH sudden death
  • PH cardiac disease
  • liver impairment
  • chronic obstructive pulmonary disease (COPD) or significant respiratory disease
  • patients at risk of electrolyte disturbances such as those on diuretics
  • ensure cardiac monitoring and resuscitation facilities are nearby in case the low risk of torsade de pointes VT eventuates, or the patient has a respiratory arrest (more likely to occur withconcurrent sedatives such as opiates and opioids, particularly if these are given rapidly iv)
  • reduce initial doses of concurrent opiates and opioids to 1/3rd of normal doses
  • pregnancy in 3rd trimester as risk of neonatal extrapyramidal effects
  • lactation
  • safety not established in children under 2yrs
  • no use of machinery or driving within 24hrs of dose if dose > 5mg (10hrs for 5mg doses)
  • elderly

P/K

  • very rapidly absorbed following intramuscular administration, and the distribution phase half-life for plasma is ~10 minutes
  • onset of action is 3-10 minutes following intravenous or intramuscular administration, although maximum effect may be delayed until 30 minutes
  • terminal plasma half life ~134 minutes
  • duration of sedative effect is 2-4 hrs, but altered consciousness may persist for up to 12 hrs

adverse effects

dose for Mx of severe agitation in ED

  • healthy adults excluding the elderly:
    • 10mg im (can be repeated every 4-6hrs prn, and doses up to 25mg im can be used), or,
    • iv infusion 25-50mg in 250ml 0.9% saline over 20 minutes up to twice daily
droperidol.txt · Last modified: 2014/05/05 16:34 (external edit)