Home Drug Guide Droperidol

Drug Guide

Generic Name

Droperidol

Brand Names Inapsine

Classification

Therapeutic: Antipsychotic, antiemetic

Pharmacological: Butyrophenone dopamine antagonist

FDA Approved Indications

  • Preoperative sedation
  • Nausea and vomiting associated with surgery or diagnostic procedures

Mechanism of Action

Droperidol blocks dopamine receptors (D2) in the chemoreceptor trigger zone and the brain's limbic system, producing sedation and antiemetic effects.

Dosage and Administration

Adult: Initial dose of 0.625 to 2.5 mg IV or IM; additional doses can be administered every 4-8 hours as needed, not to exceed 15 mg/day.

Pediatric: Use is not well established; consult specific pediatric protocols and guidelines.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Use with caution; adjust dose based on clinical response.

Hepatic Impairment: Use with caution; dose adjustment may be necessary.

Pharmacokinetics

Absorption: Well absorbed IM; IV administration provides immediate effect.

Distribution: Widely distributed; crosses blood-brain barrier.

Metabolism: Metabolized in the liver.

Excretion: Excreted primarily in urine.

Half Life: Approximately 2-4 hours.

Contraindications

  • Known hypersensitivity to droperidol or other butyrophenones.
  • Prolonged QT interval or history of QT prolongation or cardiac arrhythmias.

Precautions

  • Use with caution in patients with cardiovascular disease, electrolyte disturbances, or conditions predisposing to arrhythmias.
  • Monitor ECG in at-risk patients.

Adverse Reactions - Common

  • Drowsiness, sedation (Common)
  • Vomiting, nausea (Common)

Adverse Reactions - Serious

  • QT prolongation, Torsades de Pointes (Serious but rare)
  • Hypotension (Uncommon)
  • Extrapyramidal symptoms (Uncommon)

Drug-Drug Interactions

  • Other medications prolonging QT interval (e.g., certain antibiotics, antifungals, class Ia and III antiarrhythmics).

Drug-Food Interactions

  • None specifically noted.

Drug-Herb Interactions

  • None well documented.

Nursing Implications

Assessment: Monitor EKG for QT prolongation, blood pressure, and neurological status.

Diagnoses:

  • Risk for cardiac arrhythmias

Implementation: Administer IV or IM as ordered; monitor vital signs and cardiac rhythm closely.

Evaluation: Assess for effectiveness in nausea control and sedative effects; monitor for adverse reactions.

Patient/Family Teaching

  • Report chest pain, palpitations, or dizziness.
  • Avoid sudden movements if experiencing dizziness or sedation.
  • Inform about potential QT prolongation and need for monitoring.

Special Considerations

Black Box Warnings:

  • Significant risk of QT prolongation and Torsades de Pointes; contraindicated in patients with long QT syndromes or concurrent QT-prolonging drugs.

Genetic Factors: Genetic predispositions affecting cardiac repolarization may increase risk.

Lab Test Interference: May prolong QT interval on ECG.

Overdose Management

Signs/Symptoms: Severe hypotension, cardiac arrhythmias, extrapyramidal symptoms, excessive sedation.

Treatment: Supportive care; manage arrhythmias with appropriate antiarrhythmic drugs; correct electrolyte imbalances; provide symptomatic and supportive care.

Storage and Handling

Storage: Store at room temperature, protected from light.

Stability: Stable under recommended conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.