Droperidol
Mechanism :
The exact mechanism of action is unknown, however, droperidol causes a CNS depression at subcortical levels of the brain, midbrain, and brainstem reticular formation. It may antagonize the actions of glutamic acid within the extrapyramidal system. It may also inhibit catecholamine receptors and the reuptake of neurotransmitters and has strong central antidopaminergic action and weak central anticholinergic action. It can also produce ganglionic blockade and reduced affective response.
The main actions seem to stem from its potent Dopamine receptor antagonism with minor antagonistic effects on alpha-1 adrenergic receptors as well.
Indication :
Contraindications :
Hypersensitivity; Known or suspected QT prolongation, congenital long QT syndrome.
Dosing :
2-12 years:
0.03-0.07 mg/kg IV/IM over 2-5 minutes every 4-6 hours as per requirement; Max: 0.1 mg/kg. Additional doses to be given after evaluating risk-benefit ratio.
Adverse Effect :
Hypotension, tachycardia, QT prolongation, torsades de pointes, cardiac arrest, ventricular tachycardia, extrapyramidal reactions, anxiety, hyperactivity, drowsiness, dizziness, hallucinations, restlessness, tardive dyskinesia, parkinsonism, oculogyric crisis, delirium, altered temperature regulation, laryngospasm, bronchospasm, anaphylaxis, neuroleptic malignant syndrome, constipation, weight gain.
Interaction :
Use with any drug that prolongs QT interval is not recommended.
Diuretics, Laxatives and Mineralocorticoids: May cause hypokalaemia and hypomagnesemia and increase risk of QT elongation.
CNS depressants: Additive effect with CNS depressants.
Adrenaline: May cause decrease in BP with adrenaline.
Atropine: May cause tachycardia with atropine.
Hepatic Dose :
Use with caution. Adjust dose as per clinical response.