Droperidol

[cruiseforever]

I know Droperidol is on FDA's black box list. But I have seen an increase in the usage of Droperidol by the ERs. It is given to pysch pt.s without a 12 lead being done. With the concern on side effects decreasing. Is there anyone using it on the streets?

It was a wonderful drug for us. Our sysem is getting ready to redo it's protcols and I was thinking of adding this to the list.

 

[chaz90]

There's been some discussion that Droperidol's effects on QT prolongation may have been exaggerated and that Haloperidol's side effect profile may in fact be worse. We'll see if it comes back. I haven't heard of anyone carrying it pre-hospitally, but I'm certain someone out there is. Reality is, plenty of medications have Black Box warnings and are still frequently utilized. See Coumadin and Avandia for two easy examples. Both have had warnings for years, but are still widespread amongst our patients. Quick sidenote, but I find it interesting that the warning for Coumadin is related to it's increased risk of bleeding to death. Go figure huh?

 

[Carlos Danger]

I used to have droperidol prehospital. Great drug.

The QT prolongation in the study that prompted the BBW occurred at doses something like 10x what is normally used.

Zofran and promethazine have both been shown to cause more QT prolongation than droperidol, at equivalent doses.

 

[Ensihoitaja]

We've been carrying droperidol on the ambulance in Denver for a couple years now. There was a published study from our first year of data. If I recall correctly, there were no clinically significant episodes of QT prolongation.

We can give 5 mg IV or IM and we can give additional doses with base contact.

 

[Fish]

I know Droperidol is on FDA's black box list. But I have seen an increase in the usage of Droperidol by the ERs. It is given to pysch pt.s without a 12 lead being done. With the concern on side effects decreasing. Is there anyone using it on the streets?

It was a wonderful drug for us. Our sysem is getting ready to redo it's protcols and I was thinking of adding this to the list.

Williamson County EMS in Texas uses it, high dose for Combative patients 10mg IM standing order, and Low Dose for Nausea 2.5mg IV/IM standing order not relieved by Zofran or if Zofran is not available.

 

[fast65]

We carry droperidol as well. We're using 2.5-5 mg IM/IV for combative patients, and 1.25 mg for nausea.

 

[Christopher]

I know Droperidol is on FDA's black box list. But I have seen an increase in the usage of Droperidol by the ERs. It is given to pysch pt.s without a 12 lead being done. With the concern on side effects decreasing. Is there anyone using it on the streets?

It was a wonderful drug for us. Our sysem is getting ready to redo it's protcols and I was thinking of adding this to the list.

We've used 1.25-2.5mg for many years.

Please ignore the ridiculous black box warning (turns out if you give 20-50mg IV, you can maybe run into some complications, although nobody knows for certain).

 

[BigBad]

Have a standing order for 5mg and 5mg repeat. Its a beautiful thing.

 

[jwk]

All you need for anti-emetic effect is 0.625mg - usually 1/4 cc. 1.25mg is probably OK, 2.5mg is absurdly high. Droperidol used to be used a lot in anesthesia for it's disocciative properties about 30 years ago. It was even combined with fentanyl into a single medication called Innovar. We abandoned using drop for any of its sedative/hypnotic effect about 25 years ago, because at higher doses (that would be anything above 1.25mg) patients were complaining about side effects (which is actually what we looked for in anesthesia, but patients hated waking up from it). At low doses, it's a great anti-emetic with few side effects.