Droperidol (When ATH N05AD08)

When ATH:
N05AD08

Characteristic.

Anxiolytic, butyrophenone derivative. The crystalline powder of white or light tan color, without smell. Practically insoluble in water, slightly soluble ethanol. When stored in air and exposed to light yellow. Molecular weight 379,43.

Pharmacological action.
Antipsychotic, sedation, antiemetic, protivoshokovoe.

Application.

Neuroleptanalgesia (usually in combination with other opioids fentanyl or), premedication, to prepare for the instrumental studies, incl. endoscopic and surgical procedures; vvodnaya anesthesia, potentiation of general anesthesia, psychomotor agitation in the postoperative period, painful shock (incl. myocardial infarction, burns), poisoning (in the complex therapy); в наркологии — алкогольный делирий.

Contraindications.

Hypersensitivity, extrapyramidal disorders, appointment during cesarean section, kaliopenia, hypotension, long QT syndrome, natural infancy (to 2 years).

Restrictions apply.

Hepatic and / or renal failure, alcoholism, decompensated chronic heart failure, epilepsy, depression.

Pregnancy and breast-feeding.

The on / droperidol administered to rats caused a slight increase in the number of deaths of newborn rats at doses, exceeding MRDC in 4,4 times. Droperidol had no teratogenic effects in animals.

During pregnancy used in cases, when the intended benefits to the mother outweighs the potential risk to the fetus. Contraindicated in late pregnancy (such as cesarean section).

Category actions result in FDA - C. (The study of reproduction in animals has revealed adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not held, However, the potential benefits, associated with drugs in pregnant, may justify its use, in spite of the possible risk.)

It should not be used during breastfeeding (unknown, Is droperidol excreted into breast milk).

Side effects.

Cardio-vascular system and blood (hematopoiesis, hemostasis): low blood pressure, tachycardia.

From the nervous system and sensory organs: disforija, drowsiness in the postoperative period; при использовании в высоких дозах — тревожность, fear, hypererethism, extrapyramidal disorders; there are reports of postoperative hallucinations (sometimes associated with transient periods of depression).

Редко — головокружение, chills and / or shivering, laringospazm, bronchospasm, anaphylactic reactions. When combined administration of droperidol with fentanyl or other parenteral analgesics may increase the blood pressure (regardless of the presence / absence of prior hypertension).

Cooperation.

It enhances the effect of benzodiazepines, ʙarʙituratov, Opioid analgesics, hypnotic and anesthetic agents, muscle relaxants and antihypertensives. It weakens the effect of dopamine receptor agonists (bromocriptine). It reduces the pressor effect of epinephrine.

Overdose.

Symptoms: a sharp decrease in blood pressure, increased severity of side effects.

Treatment: simptomaticheskaya therapy, at occurrence of extrapyramidal disorders used holinoliticheskie funds, BP reduction cropped analeptikami and sympathomimetic agents, hypovolemia shows compensation bcc.

Dosing and Administration.

B /, / m. Dosage regimen individual, depending on the evidence, age, weight and general condition of the patient. For sedation: взрослым — 2,5–5 мг в/м, 15-45 minutes prior to surgery; Children - 100 ug / kg body weight. For the induction of anesthesia: взрослым — в/в 15–20 мг, детям — в/в 200–400 мкг/кг массы тела или в/м 300–600 мкг/кг массы тела. When the duration of operations in order to maintain anesthesia may re maintenance dose of 2.5-5 mg. В послеоперационном периоде взрослым назначают 2,5–5 мг в/м с интервалом 6 no. При инфаркте миокарда — в/в 5–10 мг в зависимости от величины АД в сочетании с фентанилом.

Precautions.

To prevent orthostatic hypotension should be taken when transporting a patient (can not quickly change the position of the body). Elderly and physically debilitated patients is recommended to reduce the initial dose. Patients, receiving antihypertensives, a few days before the use of droperidol need to gradually reduce the dose of these drugs, а затем — их полная отмена. In patients with pheochromocytoma after administration of droperidol may experience severe hypertension and tachycardia.

Appointment to the increased dose (25 mg, and more) It can cause sudden death in patients with heart rhythm disturbances (incl. to hypoxia, electrolyte imbalance).

During use on a conduction anesthesia (Spinal, epidural) possible development of the blockade of the intercostal nerves and the sympathetic nervous system, making it difficult to breath, enhances peripheral vascular hypotension.

Cautions.

Droperidol is used only in hospital.