We've added 2 more medications to the PDF version of Cafer's Psychopharmacology: Visualize to Memorize 270 Medication Mascots, so now there are actually 280 mascots. The other new mascot in the PDF is amisulpride (BARHEMSYS).
Droperidol (INAPSINE)
Pronounced: dro PER i dol / IN ap seen
Droperidol (Inapsine) is a parenteral antiemetic that is also a first-generation antipsychotic (FGA) similar to haloperidol (Haldol). Droperidol is not approved for any psychiatric indication but is used off-label in emergency departments as an intramuscular injection for acute behavioral disturbance.
Intramuscular droperidol 5 mg was similar in efficacy to intramuscular olanzapine (Zyprexa) 10 mg for acute agitation (Cole et al, 2021). Time to adequate sedation was about 17 minutes (range 10–30 minutes) with either medication. Extrapyramidal adverse effects were more common with droperidol (1%) than with olanzapine (0.1%). Note that olanzapine is also effective as an off-label antiemetic.
Droperidol has a black box warning of risk of QT prolongation. The FDA advised that an electrocardiogram should be obtained prior to droperidol administration and it should not be used if the QTc is > 440 msec in males or > 450 msec in females. The FDA also recommended cardiac monitoring for 2–3 hours after droperidol administration.
Dosing: For perioperative nausea/vomiting, give 0.625–1.25 mg IM or IV every 3–4 hr PRN. FDA maximum is 2.5 mg/dose. Slow IV push over 2–5 minutes. For acute agitation, 5 mg IM is the usual dose. EKG monitoring of QT interval is required.
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