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"Droperidol" AND "Emergency"

Farah Khorassani, Maha Saad
OBJECTIVE: The purpose of this review is to summarize the current evidence of the off-label use of intravenous (IV) olanzapine and discuss its risks versus benefits for the management of agitation. DATA SOURCES: A literature search was conducted to gather relevant data regarding IV use of olanzapine for the management of acute agitation. PubMed, EMBASE, MEDLINE, and IPA were searched using the keywords and MESH terms: olanzapine, intravenous, IV, off-label, and agitation...
February 13, 2019: Annals of Pharmacotherapy
Lauren R Klein, Brian E Driver, Gabriella Horton, Sarah Scharber, Marc L Martel, Jon B Cole
BACKGROUND: Rapid treatment of agitation in the emergency department (ED) is critical to avoid injury to patients and providers. Treatment with intramuscular antipsychotics is often utilized, but there is a paucity of comparative effectiveness evidence available. OBJECTIVE: The purpose of this investigation was to compare the effectiveness of droperidol, olanzapine, and haloperidol for treating agitation in the ED. METHODS: This was a retrospective observational study of adult patients who received intramuscular medication to treat agitation...
February 8, 2019: Journal of Emergency Medicine
Maarten Bak, Irene Weltens, Chris Bervoets, Jürgen De Fruyt, Jerzy Samochowiec, Andrea Fiorillo, Gaia Sampogna, Przemyslaw Bienkowski, W Ulrich Preuss, Blazej Misiak, Dorota Frydecka, Agnieszka Samochowiec, Emma Bak, Marjan Drukker, Geert Dom
INTRODUCTION: Non-pharmacological interventions preferably precede pharmacological interventions in acute agitation. Reviews of pharmacological interventions remain descriptive or compare only one compound with several other compounds. The goal of this study is to compute a systematic review and meta-analysis of the effect on restoring calmness after a pharmacological intervention, so a more precise recommendation is possible. METHOD: A search in Pubmed and Embase was done to isolate RCT's considering pharmacological interventions in acute agitation...
February 2, 2019: European Psychiatry: the Journal of the Association of European Psychiatrists
Colin B Page, Lachlan E Parker, Stephen J Rashford, Katherine Z Isoardi, Geoffrey K Isbister
STUDY OBJECTIVE: Although uncommon, children (<16 years) with acute behavioural disturbance are a significant issue for emergency medical service providers. In this study we aimed to investigate the safety and effectiveness of droperidol in children with prehospital acute behavioural disturbance. METHODS: This was a prospective observational study over 1 year investigating the use of droperidol (0.1-0.2 mg/kg) for children (< 16 y) with acute behavioural disturbance...
October 31, 2018: Prehospital Emergency Care
Robert Meek, Michaela J Mee, Diana Egerton-Warburton, Andis Graudins, Alastair Meyer, Pourya Pouryahya, Gabriel Blecher, James Fahey, Sallyanne Crow
OBJECTIVE: To separately compare effectiveness of intravenous (IV) droperidol 1.25 mg and ondansetron 8 mg IV with 0.9% saline placebo for adult emergency department (ED) patients with nausea. A novel primary outcome measure, expected to aid clinical interpretation of reported results, was employed. METHODS: A randomised controlled trial was conducted at the three EDs of Monash Health, Melbourne, Australia. Design was to demonstrate superiority of the active drugs over placebo...
October 28, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
James R Miner, Lauren R Klein, Jon B Cole, Brian E Driver, Johanna C Moore, Jeffrey D Ho
STUDY OBJECTIVE: We seek to determine the characteristics and prevalence of agitation among patients in an urban county emergency department (ED). METHODS: This was a prospective observational study of ED patients at an urban Level I trauma center. All ED patients were screened during daily randomized 8-hour enrollment periods. Adult agitated patients, defined as having an altered mental status score greater than 1, were included. Trained research volunteers collected demographics and baseline data, including the presenting altered mental status score, use and type of restraints, and whether any initial sedative was given...
October 2018: Annals of Emergency Medicine
Maxine X Patel, Faisil N Sethi, Thomas Re Barnes, Roland Dix, Luiz Dratcu, Bernard Fox, Marina Garriga, Julie C Haste, Kai G Kahl, Anne Lingford-Hughes, Hamish McAllister-Williams, Aileen O'Brien, Caroline Parker, Brodie Paterson, Carol Paton, Sotiris Posporelis, David M Taylor, Eduard Vieta, Birgit Völlm, Charlotte Wilson-Jones, Laura Woods
The British Association for Psychopharmacology and the National Association of Psychiatric Intensive Care and Low Secure Units developed this joint evidence-based consensus guideline for the clinical management of acute disturbance. It includes recommendations for clinical practice and an algorithm to guide treatment by healthcare professionals with various options outlined according to their route of administration and category of evidence. Fundamental overarching principles are included and highlight the importance of treating the underlying disorder...
June 2018: Journal of Psychopharmacology
Pei-Chun Lai, Yen-Ta Huang
Droperidol is a short-acting, potent dopamine D2 antagonist that can pass through the blood-brain barrier. A black box warning was issued for droperidol by the United States Food and Drug Administration in 2001 because of a risk of development of torsades de pointes induced by QT prolongation. Many experts feel that the incidence of arrhythmia is overestimated, and low-dose droperidol is almost always used by anesthesiologists for postoperative nausea and vomiting. In this review, we used evidence-based analysis to appraise high-quality studies with a low risk of bias published after 2001 on the use of droperidol in the emergency department (ED)...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
Celene Y L Yap, Ya-Seng Arthur Hsueh, Jonathan C Knott, David McD Taylor, Esther W Chan, David C M Kong
BACKGROUND: The combination of midazolam and droperidol has proven superior to droperidol or olanzapine monotherapy in the management of acute agitation in emergency departments (EDs). OBJECTIVE: This is the first economic analysis to evaluate the cost-benefit and cost effectiveness of the midazolam-droperidol combination compared with droperidol or olanzapine for the management of acute agitation in EDs. METHODS: This analysis used data derived from a randomised, controlled, double-blind clinical trial conducted in two metropolitan Australian EDs between October 2014 and August 2015...
June 2018: PharmacoEconomics Open
Colin B Page, Lachlan E Parker, Stephen J Rashford, Emma Bosley, Katherine Z Isoardi, Frances E Williamson, Geoffrey K Isbister
STUDY OBJECTIVE: Acute behavioral disturbance is a common problem for emergency medical services. We aimed to investigate the safety and effectiveness of droperidol compared to midazolam in the prehospital setting. METHODS: This was a prospective before and after study comparing droperidol to midazolam for prehospital acute behavioral disturbance, when the state ambulance service changed medications. The primary outcome was the proportion of adverse effects (airway intervention, oxygen saturation < 90%, respiratory rate < 12, systolic blood pressure < 90 mmHg, sedation assessment tool score -3 and dystonic reactions) in patients receiving sedation...
November 2018: Prehospital Emergency Care
Leslie S Zun
BACKGROUND: The main goal of antipsychotic medication in the management of acute agitation in the emergency department is to rapidly induce calm without oversedation, enabling patients to participate in their own care. However, there is a paucity of comparative studies, particularly with newer fast-acting second-generation antipsychotic agents. OBJECTIVE OF THE REVIEW: This structured evidence-based review compared the onset of efficacy of antipsychotic treatments for acute agitation using data from randomized controlled trials identified by a literature search of the PubMed database...
March 2018: Journal of Emergency Medicine
Ryuhei Araki, Kazuko Hayashi, Teiji Sawa
BACKGROUND: Although midbrain dopaminergic pathways are known to contribute to arousal and emergence from anesthesia, few reports exist regarding the anesthetic effects of dopamine D2 receptor antagonism in humans. This study examined the effect of the D2 receptor antagonist droperidol on sevoflurane anesthesia by examining α and slow wave electroencephalogram oscillations. METHODS: Forty-five patients, age 20 to 60 yr, were enrolled. Frontal electroencephalograms were continuously collected for offline analysis via Bispectral Index monitoring...
April 2018: Anesthesiology
Celene Y L Yap, David McD Taylor, Jonathan C Knott, Simone E Taylor, Georgina A Phillips, Jonathan Karro, Esther W Chan, David C M Kong, David J Castle
AIM: To examine the efficacy and safety of (1) midazolam-droperidol versus droperidol and (2) midazolam-droperidol versus olanzapine for methamphetamine-related acute agitation. DESIGN AND SETTING: A multi-centre, randomized, double-blind, controlled, clinical trial was conducted in two Australian emergency departments, between October 2014 and September 2015. PARTICIPANTS: Three hundred and sixty-one patients, aged 18-65 years, requiring intravenous medication sedation for acute agitation, were enrolled into this study...
July 2017: Addiction
David McD Taylor, Celene Y L Yap, Jonathan C Knott, Simone E Taylor, Georgina A Phillips, Jonathan Karro, Esther W Chan, David C M Kong, David J Castle
STUDY OBJECTIVE: We aim to determine the most efficacious of 3 common medication regimens for the sedation of acutely agitated emergency department (ED) patients. METHODS: We undertook a randomized, controlled, double-blind, triple-dummy, clinical trial in 2 metropolitan EDs between October 2014 and August 2015. Patients aged 18 to 65 years and requiring intravenous medication sedation for acute agitation were enrolled and randomized to an intravenous bolus of midazolam 5 mg-droperidol 5 mg, droperidol 10 mg, or olanzapine 10 mg...
March 2017: Annals of Emergency Medicine
Murray G Tucker, Sebastian Kekulawala, Michelle Kent, Sam Mostafa, Richard Harvey
BACKGROUND: The high prevalence of comorbid illicit drug use in persons with chronic psychotic illness represents a strong determinant of psychotic relapse and rehospitalization. Epidemiological studies indicate changing patterns of illicit drug use in Australia, which are concerning because of increased use of crystal methamphetamine, also known as "ice." An important complication of habitual use of crystal methamphetamine is the development of a dose-dependent acute psychotic reaction...
September 6, 2016: Journal of Medical Case Reports
Geoffrey K Isbister, Nicholas A Buckley
No abstract text is available yet for this article.
December 2016: Australian and New Zealand Journal of Psychiatry
Geoffrey Kennedy Isbister, Leonie A Calver, Michael A Downes, Colin B Page
STUDY OBJECTIVE: We investigate the effectiveness and safety of ketamine to sedate patients with severe acute behavioral disturbance who have failed previous attempts at sedation. METHODS: This was a prospective study of patients given ketamine for sedation who had failed previous sedation attempts. Patients with severe acute behavioral disturbance requiring parenteral sedation were treated with a standardized sedation protocol including droperidol. Demographics, drug dose, observations, and adverse effects were recorded...
May 2016: Annals of Emergency Medicine
Marc L Martel, Lauren R Klein, Robert L Rivard, Jon B Cole
BACKGROUND: Olanzapine is an atypical antipsychotic with similar pharmacologic properties to droperidol. Due to the current droperidol shortage, the authors' clinical practice has been to substitute olanzapine for droperidol in many situations. At this time, olanzapine is U.S. Food and Drug Administration approved for oral and intramuscular (IM) use only, but due to its increased utility, intravenous (IV) olanzapine was recently approved for use in the study emergency department (ED)...
January 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Ashleigh Campillo, Edward Castillo, Gary M Vilke, Austin Hopper, Victoria Ryan, Michael P Wilson
BACKGROUND: Although first-generation antipsychotics (FGAs) have long been used in the emergency department (ED) to treat acute agitation, little is known about how these medications are used in modern clinical practice. In particular, little work has been published about whether ED clinicians administer FGAs with adjunctive medications in accordance with expert guidelines or the prescribing practices of FGAs over time. OBJECTIVES: 1) To provide a comparison of the frequency with which FGAs are administered with adjunctive benzodiazepines or anticholinergic medications...
December 2015: Journal of Emergency Medicine
Jeremy S Furyk, Robert A Meek, Diana Egerton-Warburton
BACKGROUND: Nausea and vomiting is a common and distressing presenting complaint in emergency departments (ED). The aetiology of nausea and vomiting in EDs is diverse and drugs are commonly prescribed. There is currently no consensus as to the optimum drug treatment of nausea and vomiting in the adult ED setting. OBJECTIVES: To provide evidence of the efficacy and safety of antiemetic medications in the management of nausea and vomiting in the adult ED setting. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 8), MEDLINE (OvidSP) (January 1966 to August 2014), EMBASE (OvidSP) (January 1980 to August 2014) and ISI Web of Science (January 1955 to August 2014)...
September 28, 2015: Cochrane Database of Systematic Reviews
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