Droperidol

Question 1

Droperidol Mechanism of Action

Answer 1

• Droperidol blocks dopamine and alpha receptors centrally, resulting in sedation, reduced agitation and a state of mental detachment.

Question 2

Droperidol Indications

Answer 2

Patients aged greater than or equal to 12 years with agitated delirium causing a mild to moderate risk to safety, when olanzapine has not been administered
or is ineffective.

Question 3

Droperidol Contraindications

Answer 3

Known Severe Allergy

Question 4

Droperidol Cautions

Answer 4

Parkinson’s disease. There is a risk of worsening the movement disorder associated with Parkinson’s disease.
Concurrent administration of other sedatives. This will increase and prolong the effects.
Intoxication. This will increase and prolong the effects.
Elderly and/or frail. These will increase and prolong the effects.

Question 5

Droperidol Use in pregnancy/breastfeeding

Answer 5

Safety has not been demonstrated. The likelihood of a pregnant or breastfeeding patient requiring droperidol is very low, but it should be administered if indicated.

Question 6

Droperidol Dose

Answer 6

10 mg IM or IV.
7.5mg appropriate for most patients - IM volume issue
• Reduce the dose to 5 mg if the patient is frail.
• The dose may be repeated once after 20 minutes.

Question 7

Droperidol Administration

Answer 7

IM or IV undiluted 
Lateral thigh preferred
Otherwise Lateral upper arm.
IV over 1-2 minutes
IV and IM administration have same onset, don't delay for IV access

Question 8

Droperidol Adverse effects

Answer 8

Hypotension - particularly if IV dose is given quickly

Question 9

Droperidol Onset of effect

Answer 9

5-10 minutes

Question 10

Droperidol duration of effect

Answer 10

4-6 hours

Question 11

Droperidol Preparation

Answer 11

2.5mg/1ml

Question 12

Droperidol Pharmacokinetics

Answer 12

• Droperidol is predominantly metabolised in the liver with metabolites being excreted in the urine.
• There are no significant effects from liver impairment on acute administration.

Question 13

Droperidol Common interactions

Answer 13

• Intoxication. Droperidol will have increased sedative effects if the patient is intoxicated with alcohol or has taken recreational drugs.
• Sedative drugs. Concurrent administration with other sedative drugs (such as olanzapine or midazolam) will result in an increased sedative effect.

Question 14

Droperidol Additional information

Answer 14

• Droperidol has been reported to prolong the QT interval. This generally involved repeated and/or high doses and one or two doses are safe, even if the
patient is known to have a prolonged QT interval.
• Droperidol may cause dyskinesia (abnormal, uncoordinated and involuntary movements) but this is unusual following one or two doses.

Question 15

Droperidol acts on which receptors?

Answer 15

Dopamine
Muscarinic
Histamine
A-1

Question 16

Droperidol Hypothesis - Dopamine agonists

Answer 16

May induce Paranoid psychosis and make schizophrenia worse

Question 17

Droperidol Hypothesis - Dopamine antagonists

Answer 17

Reduce psychotic symptoms

May produce parkinsonian side effects

Question 18

Droperidol 4 Dopamine pathways are responsible for what?

Answer 18

Mesocortical* - Thought, memory, attention, emotional behavior
Mesolimbic* - Pleasure, emotions, perception, addiction.
Nigrostriatal - Control of movement (parkinsons)
Tuberoinfundibular - Endocrine system
* Overactivity attributed to schizophrenic symptoms

Question 19

Droperidol Mechanism of hypotension as adverse affect?

Answer 19

Alpha 1 receptor antagonism - causes peripheral blood vessel vasodilation

Question 20

Muscarinic receptors

Answer 20

Activated by Acetylcholine

Responsible for Parasympathetic NS activation