Droperidol Flashcards
Droperidol
Pharmacology
3 points
*Droperidol is an antipsychotic drug from the butyrophenone group.
* Droperidol produces marked tranquillisation and sedation. It also produces an antiemetic effect and increases other CNS depressants, e.g. narcotic analgesics.
* Droperidol produces mild alpha-adrenergic blockade, peripheral vascular dilatation and reduction of the pressor effect of adrenaline.
Droperidol
Metabolism
2 points
- Droperidol is metabolised in the liver and excreted as inactive metabolites through the biliary/renal system.
- The onset of action is from three to ten minutes following intravenous or intramuscular administration. The full effect,
however, may not be apparent for 30 minutes. The duration of the sedative and tranquillising effects of droperidol generally
is two to four hours. Alteration of consciousness may persist as long as 12 hours.
Droperidol
Route Onset Duration Half-Life
All routes
Droperidol
Route Onset Duration Half-Life
All Routes 3-10min 2-4 hours N/A
Droperidol
Indications
CPG Specific Indication/s
* Behavioural disturbance.
Protocol Specific Indication/s
* Palliative care (S9).
Droperidol
Contraindications 3
⛔ Allergy or hypersensitivity to droperidol.
⛔ Patients < 6 years of age.
⛔ Patients with Parkinson’s disease.
Droperidol
Adverse/Side Effects
Common
Infrequent
Rare
- Common (>1%) – sedation, anxiety, agitation, extrapyramidal reactions, orthostatic hypotension, tachycardia, blurred
vision, mydriasis, constipation, nausea, dry mouth, urinary retention. - Infrequent (0.1 – <1%) – prolonged QT interval.
- Rare (<0.1%) – torsades de pointes, sudden cardiac death, neuroleptic malignant syndrome.
Droperidol
Precautions/Warnings
- Droperidol may prolong QT interval. Risk assessment and ECG monitoring is recommended in patients with cardiovascular disease or significant risk factors for cardiac arrhythmia. When used for severe behavioural disturbances, ECG is recommended once acute symptoms have resolved.
- Droperidol may cause mild to moderate hypotension.
- Use in the elderly - The initial dose of droperidol should be reduced in the elderly, debilitated and other poor risk patients. The effect of the initial dose should be considered in determining incremental doses.
- Effects on Ability to Drive and Use Machines - Droperidol may impair mental and/or physical abilities for operating machinery or driving a motor vehicle. Patients must be advised to only drive or operate a machine if sufficient time has elapsed after the administration of droperidol, i.e. about 10 hours after a dose of up to 5 mg and 24 hours after higher doses.
Droperidol
Interactions
2
- Droperidol may increase the action of sedative drugs and opiates.
- Droperidol may increase the action of anti hypertensive agents and orthostatic hypotension may occur.
Droperidol
Palliative Care
2 indications
Nausea and/or vomiting in the last days of life
Restlessness and/or agitation in the last days of life (first line)
Droperidol
Pal care nausea/vomiting
ADULT ONLY Dose
SC/IM/IV 0.5mg
Repeat in 4 hours
Max 1.5mg in 24hr period
Droperidol
Pal care Restlessness +/- agitation
ADULT ONLY Dose
SC/IM/IV 1.25mg
Repeat in 15min
Max 2.5mg
Max 5mg in 24hr period
Droperidol
Behavioural Disturbance
Indication
Second Line of Rx or
SAT score =>2
Droperidol
Behavioural Disturbance
Dose
Adult (14yrs or older)
IM/IV 10mg
Repeat once after 15 Min
Max total 20mg
If after additional 15min pt response still inadequate then consider Midazolam OR Ketamine under Sedation procedure
Droperidol
Behavioural Disturbance
Dose
Elderly or Frail patients
IM/IV 5mg
Repeat once after 15 Min
Max total 10mg
If after additional 15min pt response still inadequate then consider Midazolam OR Ketamine under Sedation procedure
Droperidol
Behavioural Disturbance
Dose
Children 6-14yrs
IM/IV 0.15mg/kg (not to exceed 10mg)
Repeat once after 15 Min
Max total 0.3mg/kg (not to exceed 20mg)
If after additional 15min pt responce still inadequate then consider Midazolam OR Ketamine under Sedation procedure
