droperidol

Question 1

what type of medication is it

Answer 1

class 1 antipsychotic

Question 2

droperidol is low potency meaning

Answer 2

it dose not attach as tightly to the dopamine 2 (D2) receptor as high potency ones, leading to a-adrenergic, cholinergic and histamine effects as well as dopamine receptors begin impacted

Question 3

impact of droperidol in Alpha receptors

Answer 3

blocks A receptors leading to postural hypotension,

Question 4

cholinergic effects of dreperidol

Answer 4

blocks muscarinic receptors causing dry mouth, blurred vision and difficulty with urination and constipation

Question 5

block of histamine receptors caused by droperidol leads too

Answer 5

sedative effect

Question 6

patients at risk of developing a prolonged QT interval from droperidol include…..

Answer 6

CHF, bradycardia, use of diuretics, use of other sedative

Question 7

antiemetic effect of droperidol occurs due too

Answer 7

blockage of dopamine receptor stimulation in the chemoreceptor trigger zone of the brain

Question 8

guideline mechanism of action

Answer 8

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

Question 9

Indications

Answer 9

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

Moderate to severe pain associated with one of the following, despite opiate analgesia, and ketamine is not appropriate:
Chronic or complex pain.
Chronic use of opiates.
Severe headache.
Severe pain associated with agitation.
Pain associated with severe nausea and/or vomiting.

Management of agitation or pain that does not respond to an opiate during end of life care.

Nausea and/or vomiting that persists despite ondansetron, or where motion sickness is a component of the patient’s nausea and/or vomiting

Question 10

contraindications

Answer 10

Known severe allergy.
Aged less than 12 years.
Pregnancy (analgesia and nausea and/or vomiting only).

Question 11

cautions

Answer 11

Altered level of consciousness. This will increase and prolong the effects.

Parkinson’s disease. There is a risk of worsening the movement disorder associated with Parkinson’s disease.

Concurrent administration of ketamine or midazolam. This will increase and prolong the effects.

Aged greater than or equal to 75 years, particularly if frail. The effects of droperidol will be increased and prolonged in this cohort.

Signs of shock. Droperidol may make shock worse.

Question 12

use in pregnancy?

Answer 12

The likelihood of a pregnant or breastfeeding patient requiring droperidol for acute behavioural disturbance is very low, however the balance of risk is such that it should be administered if indicated in this context.

In the context of analgesia and nausea and/or vomiting, the balance of risk is not in favour of administration of droperidol and therefore is contraindicated.

Question 13

dosage for analgesia

Answer 13

1.25 mg IV for an adult, once only. Consider reducing the dose to 0.625 mg IV if a caution is present.

Question 14

dosage for acute behavioral disturbance

Answer 14

10 mg IV or IM.

Consider reducing the dose to 5 mg if a caution is present.

The dose may be repeated once after 20 minutes.

Question 15

dose for end of life care

Answer 15

2.5 mg IV/IM/SC.
The dose may be repeated as required.

Question 16

0.625 mg IV/IM for an adult, once only.

Answer 16

dosage for nausea or vomiting

Question 17

admin for IV in ABD

Answer 17

Draw up the required dose into a 10 ml syringe and dilute to a total of 10 ml using 0.9% sodium chloride.
Administer IV over 1-2 minutes.

Question 18

IV administration for nausea and/or vomiting or as an adjunct to analgesia:

Answer 18

Draw up 2.5 mg into a 5 ml syringe and dilute to a total of 4 ml using 0.9% sodium chloride. This gives a 0.625 mg/ml solution.
Administer the required dose as an IV bolus.

Question 19

admin of IM droperidol

Answer 19

Administer undiluted. The preferred IM site is the lateral thigh. If this site is not suitable use the lateral upper arm.

Question 20

common adverse effects

Answer 20

Hypotension. This may occur if a large IV dose is administered rapidly.

Question 21

onset

Answer 21

IV/IM: 5-10 minutes.

Question 22

duration

Answer 22

4-6 H

Question 23

presentation

Answer 23

Ampoule containing 2.5 mg in 1 ml.

Question 24

common interactions

Answer 24

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