UNCONTROLLED WHEN PRINTED
Introduction
  • Droperidol is a neuroleptic, antipsychotic agent that acts on Alpha and Dopamine receptors, resulting in sedation
  • Onset of effect usually 3-5 mins both IM and IV
Indications
  • Disturbed and Abnormal Behaviour (Generally RASS 1 ~ 3) where risk to safety is evident
  • Dementia or frail patients where Olanzapine cannot be administered or is ineffective
Contraindications
  • Known allergy
  • Known Parkinson’s Disease
  • Where Ketamine has been administered to sedate this episode
  • <6 years of age
Precautions / Notes
  • Sedation of any patient <16 years of age should prompt a prior ASMA consult wherever practicable.
  • IV access in children should not be routine – sound judgement should apply
  • IV doses require sound judgement
  • Dementia patients – apply caution. Use lower doses
  • Organic causes such as suspected sepsis, traumatic brain injury or spontaneous intra-cranial event must be considered unlikely
  • ‘Agitated or Excited Delirium’, ‘Acute Behavioural Disturbance’ and ‘Drug Induced Psychosis’ are some alternative terms that may be used by other agencies
  • SpO2 and EtCO2 monitoring must be applied whenever level of consciousness drops (~RASS <0)
Management

Adults < 70 years old: 

  • IM (preferred route):
    • 5 - 10mg
  • IV:
    • 2.5 - 5mg
  • Repeat after 15mins if indicated to a total maximum cumulative dose via all routes 20mg/24hrs. Consider switch to IV Midazolam only if necessary after second dose.

Adults > 70 years of age or frail or with dementia:

  • IM (preferred route):
    • 5mg 
  • IV:
    • 2.5mg
  • Repeat after 15mins if indicated to a total maximum cumulative dose via all routes 10mg/24hrs. Consider switch to IV Midazolam only if necessary after second dose.

Paediatrics 6-15 years old:

  • IM (preferred route):
    • 0.2mg/kg to a maximum of 5mg
    • Repeat after 15mins if indicated to a total maximum cumulative dose via all routes 10mg/24hrs.
  • IV:
    • 0.2mg/kg to a maximum of 5mg 
    • Repeat after 30mins if indicated to a total maximum cumulative dose via all routes 10mg/24hrs)
Special Considerations
  • Extrapyramidal effects / Dyskinesia
  • Increased falls risk
  • Hypotension
  • Apply monitoring as soon as practicable

References
References
Presentation

10mg/2ml (equivalent to 5mg/ml)

DORM vial

DILUTION

IM

  • Do NOT dilute

IV / IO

  • Dilute 10mg/2ml with 8ml NaCl (equivalent to 1mg/ml)
MUST BE LABELLED
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Responsible Manager
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