Droperidol
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{{drugbox | IUPAC_name = 1-[1-[4-(4-fluorophenyl)-4-oxo-butyl]- 3,6-dihydro-2H-pyridin-4-yl]- 3H-benzoimidazol- 2-one | image = Droperidol.png | CAS_number = 548-73-2 | ATC_prefix = N01 | ATC_suffix = AX01 | ATC_supplemental = {{ATC|N05|AD08}} | PubChem = 3168 | DrugBank = APRD00939 | C=22 | H=22 | F=1 | N=3 | O=2 | molecular_weight = 379.428 g/mol | bioavailability = | protein_bound = | metabolism = [[Hepatic]]| elimination_half-life = 2.3 hours| pregnancy_category = C <small>([[US]])</small>| legal_status = | routes_of_administration = [[Intraveneous]], [[Intramuscular]]}}
'''Droperidol''' ('''Dropletan''', '''Dridol''' or '''Inapsine''') is an [[antidopaminergic]] [[medication|drug]] used as an [[antiemetic]] and antipsychotic. Discovered at [[Janssen Pharmaceutica]] in [[1961]], it is a [[butyrophenone]], and is a potent D<sub>2</sub> (dopamine receptor) antagonist with some [[histamine]] and [[serotonin]] antagonist activity. It has a central antiemetic action and is frequently used in the treatment of [[postoperative nausea and vomiting]] in adult doses as low as 0.625 or 1.25 mg.
It has also been used as an antipsychotic in doses ranging from 5 to 10mg given as an intramuscular injection, generally in cases of severe agitation in a psychotic patient who is refusing oral medication. However in 2001 the FDA changed the labeling requirements for droperidol injection, to include a so-called "Black Box Warning", citing concerns of [[QT prolongation]] and [[torsades de pointes]]. The evidence for this is disputed, with less than 20 reported cases of ''torsades'' in 30 years and most of those having received doses in excess of 50mg in a 24-hour period. It appears that the QT prolongation is a dose-related effect and that in low doses, droperidol is not a significant risk. Droperidol can also cause hypotension. Its use in intramuscular sedation has been replaced by intramuscular preparations of [[haloperidol]], [[midazolam]], [[clonazepam]] and [[olanzapine]].
Some practitioners recommend the use of 0.5 mg to 1 mg intravenously for the treatment of vertigo in an otherwise healthy elderly patient who hasn’t responded to Epley maneuvers.
==Side effects==
Dysphoria, Sedation, Hypotension resulting from peripheral alpha adrenoceptor blockade, Prolongation of QT interval which can lead to Torsades de Pointes,
Extrapyramidal side effects such as dystonic reactions/ neuroleptic malignant syndrome - If you experience any of the rare side-effects such as spasms of the face, one should have [[diphenhydramine]] (Benadryl) or Benztropine (Cogentin) injected into their IV to block the effects of the drug. If one is at home, fast acting Benadryl dissolving mouth strips should be taken followed by a pill.
==References==
* Scuderi PE: Droperidol: ''Many questions, few answers''. Anesthesiology 2003; 98: 289-90
* Lischke V, Behne M, Doelken P, Schledt U, Probst S, Vettermann J. ''Droperidol causes a dose-dependent prolongation of the QT interval.'' Department of Anesthesiology and Resuscitation, Johann Wolfgang Goethe-University Clinics, Frankfurt am Main, Germany.
* Emergency Medicine Magazine : http://www.emedmag.com/html/pre/tri/1005.asp
==External links==
{{General anesthetics}}
{{Antipsychotics}}
[[Category:Antiemetics]]
[[Category:Typical antipsychotics]]
[[Category:Lactams]]
[[Category:Organofluorides]]
[[Category:Ketones]]
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