#droperidol

Common Brand Names: Inapsine

Therapeutic Class: A neuroleptic butyrophenone similar to haloperidol

Common Injectable Dosage Forms:

Solution for Injection: 2.5 mg/mL in 1- and 2-mL vials and ampoules and in combination with Fentanyl

Dosage Ranges:

The usual adult IM or IV dose is 2.5-10 mg, given 30-60 minutes prior to induction of general anesthesia, or by itself for diagnostic procedures. As an adjunct for general anesthesia, 0.22-0.275 mg/kg may be given with an analgesic and/or general anesthetic. Additional doses of 1.25-2.5 mg may be necessary based on response. In children ages 2-12 years, the normal IV or IM dose is 0.088-0.165 mg/kg.

Administration and Stability: The undiluted drug (2.5 mg/mL) may be administered for both IM and direct IV injection. During general anesthesia the desired dose may be diluted with a compatible solution (LR, D5W) to a convenient volume and administered by drip infusion.

Pharmacology/Pharmacokinetics: Droperidol acts within the CNS principally at subcortical levels and exhibits a strong sedative effect, and also inhibits sympathetic postganglionic alpha-adrenergic receptor sites to produce antiemetic, but not analgesic, actions. It is rapidly absorbed with therapeutic effects seen in 3-10 minutes. The average elimination half-life is 2.3 hours as the drug is extensively metabolized in the liver and excreted in the urine and feces.

Drug and Lab Interactions: May be additive with, or potentiate, the actions of other CNS depressants. May produce an acute encephalopathic syndrome when given concomitantly with lithium.

Contraindications/Precautions: Because severe hypotension may result with droperidol use, corrective measures should be ready to initiate should this reaction occur. Caution be exercised when used with other CNS depressants (including alcohol) to avoid oversedation. Contraindicated in patients with a history of hypersensitivity to haloperidol or other butyrophenones. Pregnancy Category C.

Adverse Effects: The most common adverse effects with droperidol are hypotension and tachycardia. Other reported effects include extrapyramidal reactions and respiratory depression.