DROPERIDOL

(droe-per'i-dole)
Inapsine
Classifications: CENTRAL NERVOUS SYSTEM AGENT; BUTYROPHENONE; ANTIEMETIC
Prototype: Haloperidol
Pregnancy Category: C

Availability
2.5 mg/mL injection

Actions
Butyrophenone derivative structurally and pharmacologically related to haloperidol. Antagonizes
emetic effects of morphine-like analgesics and other drugs that act on chemoreceptor trigger
zone. Mild alpha-adrenergic blocking activity and direct vasodilator effect may cause
hypotension. Acts primarily at subcortical level to produce sedation.

Therapeutic Effects
Sedative property reduces anxiety and motor activity without necessarily inducing sleep; patient
remains responsive. Potentiates other CNS depressants. Also has antiemetic properties.

Uses
To produce tranquilizing effect and to reduce nausea and vomiting during surgical and diagnostic
procedures. Also for premedication, during induction, and as adjunct in maintenance of general
or regional anesthesia. Principally used in fixed combination with the potent narcotic analgesic
fentanyl (Innovar) to produce neuroleptanalgesia (quiescence, reduced motor activity, and
indifference to pain and environmental stimuli) to permit carrying out a variety of diagnostic and
minor surgical procedures.

Unlabeled Uses
IV antiemetic in cancer chemotherapy.

Contraindications
Known intolerance to droperidol. Safe use during pregnancy (category C), lactation, or in
children <2 y is not established.

Cautious Use

Older adult, debilitated, and other poor-risk patients; Parkinson's disease; hypotension; liver,
kidney, cardiac disease; cardiac bradyarrhythmias.

Route & Dosage

Premedication

Adult: IV/IM 2.510 mg 3060 min preoperatively

Child: IV/IM 212 y, 0.0880.165 mg/kg 3060 min preoperatively
Maintenance of General Anesthesia

Adult: IV/IM Induction, 0.220.275 mg/kg; Maintenance, 1.252.5 mg

Child: IV/IM 212 y, 0.0880.165 mg/kg

Administration
Intramuscular

Give deep IM into a large muscle.

Intravenous

IV administration to infants and children: Verify correct rate of IV injection with

physician.

PREPARE: Direct: Give undiluted.

ADMINISTER: Direct: Give at a rate of 10 mg or fraction thereof over 3060 s.
INCOMPATIBILITIES Solution/additive: Fluorouracil, furosemide, heparin, leucovorin, met

hotrexate, pentobarbital. Y-site: Fluorouracil, furosemide, heparin, leucovorin, methotrexa

te, nafcillin.

Store at 1530 C (5986 F), unless otherwise directed by manufacturer. Protect from
light.

Adverse Effects ( 1%)

CNS: Postoperative drowsiness, extrapyramidal symptoms: dystonia, akathisia, oculogyric crisis;
dizziness, restlessness, anxiety, hallucinations, mental depression. CV: Hypotension,
tachycardia, irregular heartbeats (prolonged QTc interval even at low doses). Other: Chills,

shivering, laryngospasm, bronchospasm.

Pharmacokinetics
Onset: 310 min. Peak: 30 min. Duration: 24 h; may persist up to 12 h. Distribution: Crosses
placenta. Metabolism: Metabolized in liver. Elimination: Excreted in urine and feces.

Nursing Implications
Assessment & Drug Effects

Monitor ECG throughout therapy. Report immediately prolongation of QTc interval.

Monitor vital signs closely. Hypotension and tachycardia are common adverse effects.

Exercise care in moving medicated patients because of possibility of severe orthostatic

hypotension. Avoid abrupt changes in position.

Observe patients for signs of impending respiratory depression carefully when receiving
a concurrent narcotic analgesic carefully.

Note: EEG patterns are slow to return to normal during the postoperative period.

Observe carefully and report promptly to physician early signs of acute dystonia: Facial
grimacing, restlessness, tremors, torticollis, oculogyric crisis. Extrapyramidal symptoms
may occur within 2448 h postoperatively.

Note: Droperidol may aggravate symptoms of acute depression.

Patient & Family Education

Do not breast feed while taking this drug without consulting physician.