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  1 / 1947 MEDLINE  
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[PMID]:27757553
[Au] Autor:Atsuta J; Inoue S; Tanaka Y; Abe K; Nakase H; Kawaguchi M
[Ad] Endereço:Department of Anesthesiology, Nara Medical University, 840 Shijo-cho, Kashihara City, Nara, 634-8521, Japan. atsutajun@gmail.com.
[Ti] Título:Fosaprepitant versus droperidol for prevention of PONV in craniotomy: a randomized double-blind study.
[So] Source:J Anesth;31(1):82-88, 2017 Feb.
[Is] ISSN:1438-8359
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Postoperative nausea and vomiting (PONV) is a common complication after craniotomy. Vomiting may be a potentially hazardous complication in neurosurgical patients. We compared the efficacy of fosaprepitant and droperidol for the prevention of PONV, vomiting in particular, after craniotomy. METHODS: Patients scheduled to undergo elective craniotomy were enrolled in the study and randomly divided in a double-blind manner into two groups to receive either 150 mg of fosaprepitant (group F) or 1.25 mg of droperidol (group D). Dexamethasone (9.9 mg) was given to all patients, except those with diabetes mellitus. The incidence of PONV, frequency of vomiting, nausea score, and use of rescue antiemetic during the first 72 h after surgery were assessed at five time intervals (0-2, 2-6, 6-24, 24-48, and 48-72 h). RESULTS: Of the 200 randomized patients eligible for entry into the study, 186 were ultimately included for analysis. There were no significant differences in demographics or intraoperative variables between the two treatment groups. Over the entire 72-h post-craniotomy observation period the overall and cumulative incidence of vomiting was significantly lower in group F patients than in group D patients, while there were no between-group differences in the overall and cumulative incidence of PONV or in complete response (no PONV and no rescue antiemetic). The incidence and frequency of vomiting during each of the five observational periods were significantly lower in group F patients than group D patients, although there were no differences in the nausea score and antiemetic use between the groups. CONCLUSION: Based on the results, fosaprepitant was more effective than droperidol in the prevention of vomiting after craniotomy over the entire 72-h study period. However, there was no difference in the incidence of nausea and antiemetic use.
[Mh] Termos MeSH primário: Antieméticos/uso terapêutico
Droperidol/uso terapêutico
Morfolinas/uso terapêutico
Náusea e Vômito Pós-Operatório/prevenção & controle
[Mh] Termos MeSH secundário: Idoso
Craniotomia/métodos
Dexametasona/administração & dosagem
Método Duplo-Cego
Procedimentos Cirúrgicos Eletivos/métodos
Feminino
Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antiemetics); 0 (Morpholines); 6L8OF9XRDC (fosaprepitant); 7S5I7G3JQL (Dexamethasone); O9U0F09D5X (Droperidol)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161021
[St] Status:MEDLINE
[do] DOI:10.1007/s00540-016-2267-1


  2 / 1947 MEDLINE  
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[PMID]:27745766
[Au] Autor:Taylor DM; Yap CYL; Knott JC; Taylor SE; Phillips GA; Karro J; Chan EW; Kong DCM; Castle DJ
[Ad] Endereço:Emergency Department, Austin Health, Heidelberg, Victoria, Australia. Electronic address: david.taylor@austin.org.au.
[Ti] Título:Midazolam-Droperidol, Droperidol, or Olanzapine for Acute Agitation: A Randomized Clinical Trial.
[So] Source:Ann Emerg Med;69(3):318-326.e1, 2017 Mar.
[Is] ISSN:1097-6760
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: We aim to determine the most efficacious of 3 common medication regimens for the sedation of acutely agitated emergency department (ED) patients. METHODS: We undertook a randomized, controlled, double-blind, triple-dummy, clinical trial in 2 metropolitan EDs between October 2014 and August 2015. Patients aged 18 to 65 years and requiring intravenous medication sedation for acute agitation were enrolled and randomized to an intravenous bolus of midazolam 5 mg-droperidol 5 mg, droperidol 10 mg, or olanzapine 10 mg. Two additional doses were administered, if required: midazolam 5 mg, droperidol 5 mg, or olanzapine 5 mg. The primary outcome was the proportion of patients adequately sedated at 10 minutes. RESULTS: Three hundred forty-nine patients were randomized to the 3 groups. Baseline characteristics were similar across the groups. Ten minutes after the first dose, significantly more patients in the midazolam-droperidol group were adequately sedated compared with the droperidol and olanzapine groups: differences in proportions 25.0% (95% confidence interval [CI] 12.0% to 38.1%) and 25.4% (95% CI 12.7% to 38.3%), respectively. For times to sedation, the differences in medians between the midazolam-droperidol group and the droperidol and olanzapine groups were 6 (95% CI 3 to 8) and 6 (95% CI 3 to 7) minutes, respectively. Patients in the midazolam-droperidol group required fewer additional doses or alternative drugs to achieve adequate sedation. The 3 groups' adverse event rates and lengths of stay did not differ. CONCLUSION: Midazolam-droperidol combination therapy is superior, in the doses studied, to either droperidol or olanzapine monotherapy for intravenous sedation of the acutely agitated ED patient.
[Mh] Termos MeSH primário: Benzodiazepinas/uso terapêutico
Sedação Consciente/métodos
Droperidol/uso terapêutico
Hipnóticos e Sedativos/uso terapêutico
Midazolam/uso terapêutico
Agitação Psicomotora/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Método Duplo-Cego
Droperidol/administração & dosagem
Quimioterapia Combinada
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Hipnóticos e Sedativos/administração & dosagem
Injeções Intravenosas
Masculino
Midazolam/administração & dosagem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Hypnotics and Sedatives); 12794-10-4 (Benzodiazepines); N7U69T4SZR (olanzapine); O9U0F09D5X (Droperidol); R60L0SM5BC (Midazolam)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170728
[Lr] Data última revisão:
170728
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161018
[St] Status:MEDLINE


  3 / 1947 MEDLINE  
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[PMID]:27976370
[Au] Autor:Khokhar MA; Rathbone J
[Ad] Endereço:Oral Health and Development, University of Sheffield, 15 Askham Court, Gamston Radcliffe Road, Nottingham, UK, NG2 6NR.
[Ti] Título:Droperidol for psychosis-induced aggression or agitation.
[So] Source:Cochrane Database Syst Rev;12:CD002830, 2016 12 15.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: People experiencing acute psychotic illnesses, especially those associated with agitated or violent behaviour, may require urgent pharmacological tranquillisation or sedation. Droperidol, a butyrophenone antipsychotic, has been used for this purpose in several countries. OBJECTIVES: To estimate the effects of droperidol, including its cost-effectiveness, when compared to placebo, other 'standard' or 'non-standard' treatments, or other forms of management of psychotic illness, in controlling acutely disturbed behaviour and reducing psychotic symptoms in people with schizophrenia-like illnesses. SEARCH METHODS: We updated previous searches by searching the Cochrane Schizophrenia Group Register (18 December 2015). We searched references of all identified studies for further trial citations and contacted authors of trials. We supplemented these electronic searches by handsearching reference lists and contacting both the pharmaceutical industry and relevant authors. SELECTION CRITERIA: We included all randomised controlled trials (RCTs) with useable data that compared droperidol to any other treatment for people acutely ill with suspected acute psychotic illnesses, including schizophrenia, schizoaffective disorder, mixed affective disorders, the manic phase of bipolar disorder or a brief psychotic episode. DATA COLLECTION AND ANALYSIS: For included studies, we assessed quality, risk of bias and extracted data. We excluded data when more than 50% of participants were lost to follow-up. For binary outcomes, we calculated standard estimates of risk ratio (RR) and the corresponding 95% confidence intervals (CI). We created a 'Summary of findings' table using GRADE. MAIN RESULTS: We identified four relevant trials from the update search (previous version of this review included only two trials). When droperidol was compared with placebo, for the outcome of tranquillisation or asleep by 30 minutes we found evidence of a clear difference (1 RCT, N = 227, RR 1.18, 95% CI 1.05 to 1.31, high-quality evidence). There was a clear demonstration of reduced risk of needing additional medication after 60 minutes for the droperidol group (1 RCT, N = 227, RR 0.55, 95% CI 0.36 to 0.85, high-quality evidence). There was no evidence that droperidol caused more cardiovascular arrhythmia (1 RCT, N = 227, RR 0.34, 95% CI 0.01 to 8.31, moderate-quality evidence) and respiratory airway obstruction (1 RCT, N = 227, RR 0.62, 95% CI 0.15 to 2.52, low-quality evidence) than placebo. For 'being ready for discharge', there was no clear difference between groups (1 RCT, N = 227, RR 1.16, 95% CI 0.90 to 1.48, high-quality evidence). There were no data for mental state and costs.Similarly, when droperidol was compared to haloperidol, for the outcome of tranquillisation or asleep by 30 minutes we found evidence of a clear difference (1 RCT, N = 228, RR 1.01, 95% CI 0.93 to 1.09, high-quality evidence). There was a clear demonstration of reduced risk of needing additional medication after 60 minutes for participants in the droperidol group (2 RCTs, N = 255, RR 0.37, 95% CI 0.16 to 0.90, high-quality evidence). There was no evidence that droperidol caused more cardiovascular hypotension (1 RCT, N = 228, RR 2.80, 95% CI 0.30 to 26.49,moderate-quality evidence) and cardiovascular hypotension/desaturation (1 RCT, N = 228, RR 2.80, 95% CI 0.12 to 67.98, low-quality evidence) than haloperidol. There was no suggestion that use of droperidol was unsafe. For mental state, there was no evidence of clear difference between the efficacy of droperidol compared to haloperidol (Scale for Quantification of Psychotic Symptom Severity, 1 RCT, N = 40, mean difference (MD) 0.11, 95% CI -0.07 to 0.29, low-quality evidence). There were no data for service use and costs.Whereas, when droperidol was compared with midazolam, for the outcome of tranquillisation or asleep by 30 minutes we found droperidol to be less acutely tranquillising than midazolam (1 RCT, N = 153, RR 0.96, 95% CI 0.72 to 1.28, high-quality evidence). As regards the 'need for additional medication by 60 minutes after initial adequate sedation, we found an effect (1 RCT, N = 153, RR 0.54, 95% CI 0.24 to 1.20, moderate-quality evidence). In terms of adverse effects, we found no statistically significant differences between the two drugs for either airway obstruction (1 RCT, N = 153, RR 0.13, 95% CI 0.01 to 2.55, low-quality evidence) or respiratory hypoxia (1 RCT, N = 153, RR 0.70, 95% CI 0.16 to 3.03, moderate-quality evidence) - but use of midazolam did result in three people (out of around 70) needing some sort of 'airway management' with no such events in the droperidol group. There were no data for mental state, service use and costs.Furthermore, when droperidol was compared to olanzapine, for the outcome of tranquillisation or asleep by any time point, we found no clear differences between the older drug (droperidol) and olanzapine (e.g. at 30 minutes: 1 RCT, N = 221, RR 1.02, 95% CI 0.94 to 1.11, high-quality evidence). There was a suggestion that participants allocated droperidol needed less additional medication after 60 minutes than people given the olanzapine (1 RCT, N = 221, RR 0.56, 95% CI 0.36 to 0.87, high-quality evidence). There was no evidence that droperidol caused more cardiovascular arrhythmia (1 RCT, N = 221, RR 0.32, 95% CI 0.01 to 7.88, moderate-quality evidence) and respiratory airway obstruction (1 RCT, N = 221, RR 0.97, 95% CI 0.20 to 4.72, low-quality evidence) than olanzapine. For 'being ready for discharge', there was no difference between groups (1 RCT, N = 221, RR 1.06, 95% CI 0.83 to 1.34, high-quality evidence). There were no data for mental state and costs. AUTHORS' CONCLUSIONS: Previously, the use of droperidol was justified based on experience rather than evidence from well-conducted and reported randomised trials. However, this update found high-quality evidence with minimal risk of bias to support the use of droperidol for acute psychosis. Also, we found no evidence to suggest that droperidol should not be a treatment option for people acutely ill and disturbed because of serious mental illnesses.
[Mh] Termos MeSH primário: Antipsicóticos/uso terapêutico
Droperidol/uso terapêutico
Transtornos Psicóticos/tratamento farmacológico
[Mh] Termos MeSH secundário: Doença Aguda
Agressão/efeitos dos fármacos
Benzodiazepinas/uso terapêutico
Haloperidol/uso terapêutico
Seres Humanos
Midazolam/uso terapêutico
Agitação Psicomotora/tratamento farmacológico
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Antipsychotic Agents); 12794-10-4 (Benzodiazepines); J6292F8L3D (Haloperidol); N7U69T4SZR (olanzapine); O9U0F09D5X (Droperidol); R60L0SM5BC (Midazolam)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170213
[Lr] Data última revisão:
170213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161216
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD002830.pub3


  4 / 1947 MEDLINE  
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[PMID]:27920502
[Au] Autor:Fang B; Wang L; Gu J; Chen F; Shi XY
[Ad] Endereço:Department of Pharmacy, Dongfeng Hospital.
[Ti] Título:Physicochemical stability of ternary admixtures of butorphanol, ketamine, and droperidol in polyolefin bags for patient-controlled analgesia use.
[So] Source:Drug Des Devel Ther;10:3873-3878, 2016.
[Is] ISSN:1177-8881
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Delivery of drug admixtures by intravenous patient-controlled analgesia is a common practice for the management of postoperative pain; however, analytical confirmation of the compatibility and stability of butorphanol tartrate, ketamine hydrochloride, and droperidol combined in ternary admixtures is not available. METHODS: Butorphanol tartrate, ketamine hydrochloride, and droperidol have been examined for compatibility and stability when combined with 0.9% sodium chloride injection stored at 4°C and 25°C with light protection for a total of 14 days. Concentrations were 0.067 mg/mL, 1.33 mg/mL, and 0.033 mg/mL for butorphanol tartrate, ketamine hydrochloride, and droperidol, respectively. Drug concentrations were determined using high-performance liquid chromatographic analysis. RESULTS: All three drugs were very stable (>97%) at 4°C and 25°C for 14 days. The ternary admixtures were initially clear and colorless throughout the observation period, and the pH value did not change significantly. CONCLUSION: The results confirm that the ternary admixture of butorphanol tartrate 0.067 mg/mL, ketamine hydrochloride 1.33 mg/mL, and droperidol 0.033 mg/mL in 0.9% sodium chloride injection were stable for 14 days when stored in polyolefin bags at 4°C and 25°C and protected from light.
[Mh] Termos MeSH primário: Analgésicos/química
Butorfanol/química
Droperidol/química
Ketamina/química
[Mh] Termos MeSH secundário: Analgesia Controlada pelo Paciente
Analgésicos/administração & dosagem
Analgésicos/isolamento & purificação
Butorfanol/administração & dosagem
Butorfanol/isolamento & purificação
Calibragem
Cromatografia Líquida de Alta Pressão
Droperidol/administração & dosagem
Droperidol/isolamento & purificação
Combinação de Medicamentos
Embalagem de Medicamentos
Estabilidade de Medicamentos
Ketamina/administração & dosagem
Ketamina/isolamento & purificação
Polienos/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics); 0 (Drug Combinations); 0 (Polyenes); 690G0D6V8H (Ketamine); 83136-87-2 (PL 732); O9U0F09D5X (Droperidol); QV897JC36D (Butorphanol)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161207
[St] Status:MEDLINE


  5 / 1947 MEDLINE  
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[PMID]:27599617
[Au] Autor:Tucker MG; Kekulawala S; Kent M; Mostafa S; Harvey R
[Ad] Endereço:Mental Health, Drugs and Alcohol Service, Barwon Health, University Hospital Geelong, Geelong, Victoria, Australia.
[Ti] Título:Polysubstance-induced relapse of schizoaffective disorder refractory to high-dose antipsychotic medications: a case report.
[So] Source:J Med Case Rep;10(1):242, 2016 Sep 06.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The high prevalence of comorbid illicit drug use in persons with chronic psychotic illness represents a strong determinant of psychotic relapse and rehospitalization. Epidemiological studies indicate changing patterns of illicit drug use in Australia, which are concerning because of increased use of crystal methamphetamine, also known as "ice." An important complication of habitual use of crystal methamphetamine is the development of a dose-dependent acute psychotic reaction. We report a case of an acute psychotic relapse in response to polydrug use most notable for multiple recent binges of crystal methamphetamine. Unlike previously described case reports, our patient's acute psychosis was refractory to ultra-high doses of multiple antipsychotic medications. This presented safety challenges due to the risk of serious side effects with high-dose antipsychotic medications. CASE PRESENTATION: A 30-year-old white man with a past history of schizoaffective disorder was brought to our emergency department by the police in a state of extreme agitation, combativeness, and paranoia after use of cannabis and crystal methamphetamine. Despite existing compliance with zuclopenthixol decanoate depot medication, he required multiple emergency injections of zuclopenthixol acetate, and regular high-dose droperidol, chlorpromazine, and lorazepam. However, he remained severely agitated and psychotic with continuous threats of harm to others. A test of antipsychotic drug metabolism by cytochrome P450 enzymes did not reveal a pharmacogenetic cause for the poor therapeutic efficacy of antipsychotic medications. His psychosis did not appear to be modified by psychoactive medications but was instead self-limited to the presence of endogenous methamphetamine within his system. He fully recovered 96 to 120 hours post-presentation and was discharged home with out-patient clinic follow-up. CONCLUSIONS: The current case highlights the challenging nature of a severe psychotic relapse precipitated by illicit substances that is resistant to medical management. High doses of multiple antipsychotic medications may be required to manage dangerous behaviors associated with these acute psychotic relapses. These patients require close monitoring for adverse effects with adjustment of dosing to ensure the optimal balance of risk versus benefit while the patient is acutely psychotic. The results are of relevance for the management of psychiatric emergencies in emergency departments and acute mental health settings.
[Mh] Termos MeSH primário: Transtornos Relacionados ao Uso de Anfetaminas/complicações
Antipsicóticos/administração & dosagem
Serviços Médicos de Emergência
Hipnóticos e Sedativos/administração & dosagem
Abuso de Maconha/complicações
Metanfetamina/efeitos adversos
Transtornos Psicóticos/tratamento farmacológico
Violência/psicologia
[Mh] Termos MeSH secundário: Adulto
Transtornos Relacionados ao Uso de Anfetaminas/tratamento farmacológico
Transtornos Relacionados ao Uso de Anfetaminas/fisiopatologia
Transtornos Relacionados ao Uso de Anfetaminas/psicologia
Clorpromazina/administração & dosagem
Clopentixol/administração & dosagem
Clopentixol/análogos & derivados
Droperidol/administração & dosagem
Esquema de Medicação
Seres Humanos
Lorazepam/administração & dosagem
Masculino
Abuso de Maconha/tratamento farmacológico
Abuso de Maconha/fisiopatologia
Abuso de Maconha/psicologia
Transtornos Psicóticos/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents); 0 (Hypnotics and Sedatives); 2HFX55AF4Y (clopenthixol decanoate); 44RAL3456C (Methamphetamine); 982-24-1 (Clopenthixol); O26FZP769L (Lorazepam); O9U0F09D5X (Droperidol); U42B7VYA4P (Chlorpromazine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170510
[Lr] Data última revisão:
170510
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160908
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-016-1031-3


  6 / 1947 MEDLINE  
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[PMID]:27483662
[Au] Autor:Toki K; Yokose M; Miyashita T; Sato H; Fujimoto H; Yamamoto S; Goto T
[Ti] Título:[Involuntary Movement of Bilateral Lower Limbs Caused by Epidural Anesthesia: A Case Report].
[So] Source:Masui;65(6):628-31, 2016 Jun.
[Is] ISSN:0021-4892
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:Regional anesthesia, especially epidural anesthesia, rarely causes involuntary movement Here we present a case of a patient who demonstrated myoclonus-like involuntary movement of the lower limbs during continuous infusion of ropivacaine, fentanyl, and droperidol through the thoracic epidural catheter. This movement disappeared when the epidural infusion was stopped, but reappeared when the epidural infusion was restarted. Naloxone did not eliminate the movement The patient was thereafter discharged uneventfully. This case and other reports in the literature suggest that involuntary movement associated with regional anesthesia is rare and self-limiting. However, careful consideration should be given to exclude other, potentially dangerous complications.
[Mh] Termos MeSH primário: Amidas/efeitos adversos
Anestesia Epidural/efeitos adversos
Droperidol/efeitos adversos
Discinesia Induzida por Medicamentos/fisiopatologia
Discinesias/fisiopatologia
Fentanila/efeitos adversos
Extremidade Inferior/fisiopatologia
[Mh] Termos MeSH secundário: Combinação de Medicamentos
Feminino
Seres Humanos
Neoplasias Pulmonares/cirurgia
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Amides); 0 (Drug Combinations); 7IO5LYA57N (ropivacaine); O9U0F09D5X (Droperidol); UF599785JZ (Fentanyl)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:160803
[Lr] Data última revisão:
160803
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160804
[St] Status:MEDLINE


  7 / 1947 MEDLINE  
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[PMID]:27422566
[Au] Autor:Isbister GK; Buckley NA
[Ad] Endereço:Clinical Toxicology Research Group, University of Newcastle, Newcastle, NSW, Australia geoff.isbister@gmail.com.
[Ti] Título:Good clinical guidelines must define the setting, patients and evidence: Benzodiazepines versus droperidol for acute behavioural disturbance in the emergency department.
[So] Source:Aust N Z J Psychiatry;50(12):1200-1202, 2016 Dec.
[Is] ISSN:1440-1614
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Agressão
Antipsicóticos/uso terapêutico
Benzodiazepinas/uso terapêutico
Droperidol/uso terapêutico
Serviço Hospitalar de Emergência/normas
Guias de Prática Clínica como Assunto/normas
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antipsychotic Agents); 12794-10-4 (Benzodiazepines); O9U0F09D5X (Droperidol)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160717
[St] Status:MEDLINE


  8 / 1947 MEDLINE  
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[PMID]:27319097
[Au] Autor:Toyonaga S; Shinozuka N; Dobashi T; Iiyori N; Sudo T
[Ti] Título:[The Effectiveness of Epidural Droperidol for Prophylaxis of Postoperative Nausea and Vomiting: A Comparative Study of Droperidol and Adrenaline].
[So] Source:Masui;65(5):516-21, 2016 May.
[Is] ISSN:0021-4892
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:BACKGROUND: Intravenous droperidol has strong evidence for antiemetic efficacy in high risk patients for prevention of postoperative nausea and vomiting (PONV). However it is not clear whether continuous epidural administration of doroperidol prevent PONV. It has been reported that epidural adrenaline decreases PONV; therefore we prospectively compared the effectiveness of epidural droperidol and adrenaline for prophylaxis of PONV. METHODS: Eighty-six patients were scheduled for abdominal gynecological surgery under general-epidural anesthesia in the study. Patients were randomly assigned to droperidol group or adrenaline group. We investigated the incidences of PONV, the frequency of using the antiemetics. RESULTS: There was no statistical difference between the groups. The incidences of PONV were 27.9% (doropeidol group) and 58.1% (adrenaline group), respectively (P = 0.0046). The frequency of the anti-emetics use were 18.6% and 41.9%, respectively (P = 0.0189). There was one patient who needed cancellation of continuous epidural administration for vomiting in adrenaline group, but no patient in doropeidol group. CONCLUSIONS: The results suggest that epidural droperidol effectively decreases PONV in high risk patients. However epidural adrenaline might be ineffective.
[Mh] Termos MeSH primário: Antieméticos/administração & dosagem
Droperidol/administração & dosagem
Epinefrina/administração & dosagem
Náusea e Vômito Pós-Operatório/prevenção & controle
[Mh] Termos MeSH secundário: Feminino
Procedimentos Cirúrgicos em Ginecologia
Seres Humanos
Injeções Epidurais
Meia-Idade
Estudos Prospectivos
[Pt] Tipo de publicação:COMPARATIVE STUDY; ENGLISH ABSTRACT; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Antiemetics); O9U0F09D5X (Droperidol); YKH834O4BH (Epinephrine)
[Em] Mês de entrada:1607
[Cu] Atualização por classe:160620
[Lr] Data última revisão:
160620
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160621
[St] Status:MEDLINE


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[PMID]:26899459
[Au] Autor:Isbister GK; Calver LA; Downes MA; Page CB
[Ad] Endereço:Clinical Toxicology Research Group, University of Newcastle, Newcastle, New South Wales, Australia; Department of Clinical Toxicology and Pharmacology, Calvary Mater Newcastle, Newcastle, New South Wales, Australia. Electronic address: geoff.isbister@gmail.com.
[Ti] Título:Ketamine as Rescue Treatment for Difficult-to-Sedate Severe Acute Behavioral Disturbance in the Emergency Department.
[So] Source:Ann Emerg Med;67(5):581-587.e1, 2016 May.
[Is] ISSN:1097-6760
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:STUDY OBJECTIVE: We investigate the effectiveness and safety of ketamine to sedate patients with severe acute behavioral disturbance who have failed previous attempts at sedation. METHODS: This was a prospective study of patients given ketamine for sedation who had failed previous sedation attempts. Patients with severe acute behavioral disturbance requiring parenteral sedation were treated with a standardized sedation protocol including droperidol. Demographics, drug dose, observations, and adverse effects were recorded. The primary outcome was the number of patients who failed to sedate within 120 minutes of ketamine administration or requiring further sedation within 1 hour. RESULTS: Forty-nine patients from 2 hospitals were administered rescue ketamine during 27 months; median age was 37 years (range 20-82 years); 28 were men. Police were involved with 20 patients. Previous sedation included droperidol (10 mg; 1), droperidol (10+10 mg; 33), droperidol (10+10+5 mg; 1), droperidol (10+10+10 mg; 11), and combinations of droperidol and benzodiazepines (2) and midazolam alone (1). The median dose of ketamine was 300 mg (range 50 to 500 mg). Five patients (10%; 95% confidence interval 4% to 23%) were not sedated within 120 minutes or required additional sedation within 1 hour. Four of 5 patients received 200 mg or less. Median time to sedation postketamine was 20 minutes (interquartile range 10 to 30 minutes; 2 to 500 minutes). Three patients (6%) had adverse effects, 2 had vomiting, and a third had a transient oxygen desaturation to 90% after ketamine that responded to oxygen. CONCLUSION: Ketamine appeared effective and did not cause obvious harm in this small sample and is a potential option for patients who have failed previous attempts at sedation. A dose of 4 to 5 mg/kg is suggested, and doses less than 200 mg are associated with treatment failure.
[Mh] Termos MeSH primário: Analgésicos/administração & dosagem
Procedimentos Clínicos
Comportamento Perigoso
Ketamina/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Sedação Consciente/métodos
Droperidol/administração & dosagem
Serviço Hospitalar de Emergência
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Analgesics); 690G0D6V8H (Ketamine); O9U0F09D5X (Droperidol)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170615
[Lr] Data última revisão:
170615
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:160223
[St] Status:MEDLINE


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[PMID]:26883844
[Au] Autor:Brakman M; de Graaff PJ; Visser EC
[Ad] Endereço:UMCG, afd. Anesthesiologie, Groningen.
[Ti] Título:[Catatonic syndrome after single low dose of droperidol].
[Ti] Título:Katatoon syndroom na eenmalige gift droperidol..
[So] Source:Ned Tijdschr Geneeskd;160:A9712, 2016.
[Is] ISSN:1876-8784
[Cp] País de publicação:Netherlands
[La] Idioma:dut
[Ab] Resumo:BACKGROUND: Patients find postoperative nausea and vomiting extremely unpleasant. If nausea persists despite initial treatment, droperidol, a butyrophenone with anti-dopaminergic activity, can be very effective. Side-effects, albeit rare, can occur and are potentially serious. CASE DESCRIPTION: A 75-year-old postoperative patient was given a single low dose of droperidol to treat persistent nausea. Subsequently, the patient developed catatonic syndrome. The psychiatrist treated the patient with benzodiazepine and electroconvulsive therapy. Within four weeks the patient had completely recovered. CONCLUSION: Catatonic syndrome is a serious condition; morbidity and mortality are mainly influenced by disease duration and early initiation of appropriate treatment. Physicians are not familiar with this syndrome. Since other syndromes and diseases may display similar symptoms, the condition is difficult to diagnose. Even after a single, low dose of droperidol, patients can be at risk of developing catatonic syndrome.
[Mh] Termos MeSH primário: Antieméticos/efeitos adversos
Catatonia/induzido quimicamente
Droperidol/efeitos adversos
[Mh] Termos MeSH secundário: Idoso
Antieméticos/uso terapêutico
Catatonia/terapia
Droperidol/uso terapêutico
Eletroconvulsoterapia
Feminino
Seres Humanos
Náusea e Vômito Pós-Operatório/tratamento farmacológico
Síndrome
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antiemetics); O9U0F09D5X (Droperidol)
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160218
[St] Status:MEDLINE



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