Droperidol – Strandmark medical

Written about Droperidol in the Emergency Department in general

Habib AS, Gan TJ. Food and Drug Administration black box warning on the perioperative use of droperidol: a review of the cases. Anesth Analg [Internet]. 2003 May [cited 2024 Jun 24];96(5):1377-1379. Available from: https://pubmed.ncbi.nlm.nih.gov/12707137/

Siegel R, Morrissey S, Mitchell E. Droperidol Use in the Emergency Department: A Clinical Review. J Emerg Med [Internet]. 2023 Mar [cited 2024 Mar 13];64(3):349-355. Available from: https://pubmed.ncbi.nlm.nih.gov/36925442/

Cisewski D, Bessler L, Mitchell G. Emergency medicine updates: Droperidol. Am J Emerg Med [Internet]. 2022 Mar [cited 2024 Mar 13];53:321-325. Available from: https://pubmed.ncbi.nlm.nih.gov/35063889/

Lai P, Huang YT. Evidence-based review and appraisal of the use of droperidol in the emergency department. Ci Ji Yi Xue Za Zhi [Internet]. 2018 Mar [cited 2024 Jun 23];30(1):37-44. Available from: https://pubmed.ncbi.nlm.nih.gov/29643708/

Mattson A, Klinkner F, Basler CS, DeVoe DC. Reintegrating droperidol into emergency medicine practice. Am J Health Syst Pharm [Internet]. 2020 Oct 30 [cited 2024 Jun 23];77(22):1829-1833. Available from: https://pubmed.ncbi.nlm.nih.gov/32839811/

Perkins J, Huckabee JD, Van Voorhis GM, D’Onofrio G. American Academy of Emergency Medicine Position Statement: Safety of Droperidol Use in the Emergency Department. J Emerg Med [Internet]. 2015 Jul [cited 2024 Mar 13];49(1):91-96. Available from: https://pubmed.ncbi.nlm.nih.gov/25837231/

Richards JR, Rockman AB. Droperidol in the emergency department: is it safe? J Emerg Med [Internet]. 2003 May [cited 2024 Mar 13];24(4):441-448. Available from: https://pubmed.ncbi.nlm.nih.gov/12745049/

Kao LW, Kirk MA, Evers SJ, Rosenfeld SH. Droperidol, QT prolongation, and sudden death: what is the evidence? Ann Emerg Med [Internet]. 2003 Apr [cited 2024 Mar 13];41(4):546-558. Available from: https://pubmed.ncbi.nlm.nih.gov/12658255/

Jackson J, Shepherd AH, Robinson JG. Evidence-based review of the black-box warning for droperidol. Am J Health Syst Pharm [Internet]. 2007 Jan 6 [cited 2024 Jun 24];64(11):1174-1178. Available from: https://pubmed.ncbi.nlm.nih.gov/17519460/

Studies of the cases that led to the FDA Black-box warning

Studies on Safety of Droperidol

Gaw CM, DeWitt CS, Beauchamp FD, Mitchell AE, Leary CM, Johnson MM. Effectiveness and safety of droperidol in a United States emergency department. Am J Emerg Med [Internet]. 2020 Jul [cited 2024 Mar 13];38(7):1444-1447. Available from: https://pubmed.ncbi.nlm.nih.gov/31831345/

Neufeld GA, Edwards KM, Jansen KA, Penberthy EM, Waller SK, McDonald ME, et al. Does low-dose droperidol administration increase the risk of drug-induced QT prolongation and torsade de pointes in the general surgical population? Anesthesiology [Internet]. 2007 Oct [cited 2024 Jun 24];107(4):531-536. Available from: https://pubmed.ncbi.nlm.nih.gov/17893447/

Yang TZT, Lee C, Itagaki AT, Grullon RD, Kasper JK. A Study of Cardiac Outcomes After Droperidol Administration in an Inpatient Psychiatric Cohort. J Clin Psychopharmacol [Internet]. 2023 Jun [cited 2024 Aug 14];43(3):223-229. Available from: https://pubmed.ncbi.nlm.nih.gov/37068031/

Tracz K, Rabinowitz O. Small doses of droperidol do not present relevant torsadogenic actions: a double-blind, ondansetron-controlled study. Br J Clin Pharmacol [Internet]. 2015 Apr [cited 2024 Mar 18];79(4):595-600. Available from: https://pubmed.ncbi.nlm.nih.gov/25293524/

Cole J, Lam SC, Marquez ML, Swanson SW, Blond MH, Mihaljevic JR. The Incidence of QT Prolongation and Torsades des Pointes in Patients Receiving Droperidol in an Urban Emergency Department. West J Emerg Med [Internet]. 2020 Feb 7 [cited 2024 Mar 13];21(4):867-872. Available from: https://pubmed.ncbi.nlm.nih.gov/32726229/

Calver L, Page CB, Downes MA, Chan B, Thomas FX, Karam D, et al. The Safety and Effectiveness of Droperidol for Sedation of Acute Behavioral Disturbance in the Emergency Department. Ann Emerg Med [Internet]. 2015 Sep [cited 2024 Jun 24];66(3):230-238. Available from: https://pubmed.ncbi.nlm.nih.gov/25890395/

Choo EK, Williams FS, Schmidt TA. Torsade de Pointes after administration of droperidol for nausea and vomiting. Prehosp Emerg Care [Internet]. 2009 Jun [cited 2024 Mar 13];13(2):261-265. Available from: https://pubmed.ncbi.nlm.nih.gov/19291568/

Hernández-Rodríguez L, Beauchamp FD, DeWitt CS, Mitchell AE, Vuong DV, Glantz AE, et al. Prospective real-time evaluation of the QTc interval variation after low-dose droperidol among emergency department patients. Am J Emerg Med [Internet]. 2022 Feb [cited 2024 Jun 23];52:123-128. Available from: https://pubmed.ncbi.nlm.nih.gov/34959024/

Indication: Headaches and Migraines

Richman PB, Rose U, Woodhouse A, Castoro CJ, Sherman AR, Dempsey JA, et al. Droperidol for acute migraine headache. Am J Emerg Med [Internet]. 1999 Jul [cited 2024 Jun 23];17(4):376-379. Available from: https://pubmed.ncbi.nlm.nih.gov/10452443/

Richman PB, Dempsey JA, Rogstad B, Moulton M, Rose U, Castoro C, et al. A randomized clinical trial to assess the efficacy of intramuscular droperidol for the treatment of acute migraine headache. Am J Emerg Med [Internet]. 2002 Jan [cited 2024 Jun 23];20(1):44-47. Available from: https://pubmed.ncbi.nlm.nih.gov/11781912/

Silberstein SD, Young WB, Mendizabal JE, Rozen TD, Arabey LB. Acute migraine treatment with droperidol: A randomized, double-blind, placebo-controlled trial. Neurology [Internet]. 2003 Jan 28 [cited 2024 Jun 23];60(2):315-321. Available from: https://pubmed.ncbi.nlm.nih.gov/12552051/

Thomas MC, Meyer ML, Salmi JS. Droperidol for the treatment of acute migraine headaches. Ann Pharmacother [Internet]. 2015 Feb [cited 2024 Mar 13];49(2):191-195. Available from: https://pubmed.ncbi.nlm.nih.gov/25416184/

Wang SJ, Silberstein SD, Young WB. Droperidol treatment of status migrainosus and refractory migraine. Headache [Internet]. 1997 Jun [cited 2024 Mar 13];37(6):372-374. Available from: https://pubmed.ncbi.nlm.nih.gov/9237411/

Weaver CS, Jones JB, Ching CD, Fortner MJ, Gallagher BK, Sakis GG, et al. Droperidol vs prochlorperazine for the treatment of acute headache. J Emerg Med [Internet]. 2004 Feb [cited 2024 Mar 13];26(2):145-150. Available from: https://pubmed.ncbi.nlm.nih.gov/14980334/

Miner JR, Fish SJ, Swanson SW, Blond MH. Droperidol vs. prochlorperazine for benign headaches in the emergency department. Acad Emerg Med [Internet]. 2001 Sep [cited 2024 Mar 13];8(9):873-879. Available from: https://pubmed.ncbi.nlm.nih.gov/11535479/

Hill CH, Martinez MJ, Marquez ML. Olanzapine versus droperidol for the treatment of primary headache in the emergency department. Acad Emerg Med [Internet]. 2008 Sep [cited 2024 Mar 13];15(9):883-889. Available from: https://pubmed.ncbi.nlm.nih.gov/19244630/

Trainor A, Miner J. Pain treatment and relief among patients with primary headache subtypes in the ED. Am J Emerg Med. 2008 Nov;26(9):1029-1034.

Stern A, Martinez A, Kincade C, Kirkland E, Braun J, Sharma J, et al. Patients treated for acute headache with intranasal droperidol spend less time in the emergency department: A retrospective observational study. Emerg Med Australas [Internet]. 2022 Oct [cited 2024 Mar 13];34(5):675-680. Available from: https://pubmed.ncbi.nlm.nih.gov/35568501/

Faine B, Coralic Z, Hudock J, Secko J. Treating primary headaches in the ED: can droperidol regain its role? Am J Emerg Med [Internet]. 2012 Sep [cited 2024 Jun 23];30(7):1416-1420. Available from: https://pubmed.ncbi.nlm.nih.gov/22030187/

Rothrock JF. Treatment of acute migraine with intravenous droperidol. Headache [Internet]. 1997 Apr [cited 2024 Jun 23];37(4):219-222. Available from: https://pubmed.ncbi.nlm.nih.gov/9150626/

Indication: Agitation

Ramsden S, Pratt A, Jackson AC, Shaner S, Fredrickson A, Wright JT, et al. A systematic review of the effectiveness and safety of droperidol for pediatric agitation in acute care settings. Acad Emerg Med [Internet]. 2022 Dec [cited 2024 Jun 23];29(12):1374-1383. Available from: https://pubmed.ncbi.nlm.nih.gov/35490341/

Allen P, Knight E, Rogers KR, Nguyen LA, Lemire AE. Comparison of Droperidol and Midazolam Versus Haloperidol and Lorazepam for Acute Agitation Management in the Emergency Department. Ann Pharmacother [Internet]. 2023 Dec [cited 2024 Mar 13];57(12):1272-1280. Available from: https://pubmed.ncbi.nlm.nih.gov/36999520/

Khokhar M, Rathbone J. Droperidol for psychosis-induced aggression or agitation. Cochrane Database Syst Rev [Internet]. 2016 Dec 15 [cited 2024 Mar 13];12(12). Available from: https://pubmed.ncbi.nlm.nih.gov/27976370/

Szwak K, Sacchetti A. Droperidol use in pediatric emergency department patients. Pediatr Emerg Care [Internet]. 2010 Apr [cited 2024 Jun 27];26(4):312-314. Available from: https://pubmed.ncbi.nlm.nih.gov/20401969/

Calver L, Drinkwater D, Page CB, Isbister GK. Droperidol vs haloperidol for sedation of aggressive behaviour in acute mental health: randomized controlled trial. Br J Psychiatry [Internet]. 2015 Mar [cited 2024 Mar 18];206(3):223-228. Available from: https://pubmed.ncbi.nlm.nih.gov/25395689/

Chan EW, Taylor DM, Knott JC, Phillips GA, Cumming DC, Kelly DM, et al. Intravenous droperidol or olanzapine as an adjunct to midazolam for the acutely agitated patient: a multicenter, randomized, double-blind, placebo-controlled clinical trial. Ann Emerg Med [Internet]. 2013 Jan [cited 2024 Mar 18];61(1):72-81.e1. Available from: https://pubmed.ncbi.nlm.nih.gov/22981685/

Yap CY, Taylor DM, Knott JC, Phillips GA, Cumming DC, Kelly DM, et al. Intravenous midazolam-droperidol combination, droperidol or olanzapine monotherapy for methamphetamine-related acute agitation: subgroup analysis of a randomized controlled trial. Addiction [Internet]. 2017 Jul [cited 2024 Mar 13];112(7):1262-1269. Available from: https://pubmed.ncbi.nlm.nih.gov/28160494/

Taylor DM, Yap CY, Knott JC, Phillips GA, Cumming DC, Kelly DM, et al. Midazolam-Droperidol, Droperidol, or Olanzapine for Acute Agitation: A Randomized Clinical Trial. Ann Emerg Med [Internet]. 2017 Mar [cited 2024 Mar 13];69(3):318-326.e1. Available from: https://pubmed.ncbi.nlm.nih.gov/27745766/

Thiemann P, Dinh R, Hammond M, Sweeney J, Johnson J, Tran AT, et al. Prospective study of haloperidol plus lorazepam versus droperidol plus midazolam for the treatment of acute agitation in the emergency department. Am J Emerg Med [Internet]. 2022 May [cited 2024 Mar 13];55:189-196. Available from: https://pubmed.ncbi.nlm.nih.gov/35287091/

Martel M, Beaudoin D, Miner JR, Blond MH. Randomized Double-blind Trial of Intramuscular Droperidol, Ziprasidone, and Lorazepam for Acute Undifferentiated Agitation in the Emergency Department. Acad Emerg Med [Internet]. 2021 Apr [cited 2024 Mar 13];28(4):383-391. Available from: https://pubmed.ncbi.nlm.nih.gov/32888340/

deSouza IF, Taylor HC, Sanguinetti PD, Rockman AJ, Kelly DM, Singer AJ. Rapid tranquilization of the agitated patient in the emergency department: A systematic review and network meta-analysis. Am J Emerg Med [Internet]. 2022 Jan [cited 2024 Mar 13];51:208-215. Available from: https://pubmed.ncbi.nlm.nih.gov/34823192/

Klein LR, Beaudoin BD, Goralnick E, Schneider S, Marquez M, Cienki JJ. Rescue Sedation When Treating Acute Agitation in the Emergency Department With Intramuscular Antipsychotics. J Emerg Med [Internet]. 2019 May [cited 2024 Jun 24];56(5):532-538. Available from: https://pubmed.ncbi.nlm.nih.gov/30745194/

Indication: Pain (other than headache)

Rech MA, Griggs C, Lovett S, Motov S. Acute pain management in the Emergency Department: Use of multimodal and non-opioid analgesic treatment strategies. Am J Emerg Med. 2022 Aug;58:57–65.

Richards JR, Rodgers IN, Gardner GO, Derlet RW. Droperidol analgesia for opioid-tolerant patients. J Emerg Med [Internet]. 2011 Oct [cited 2024 Mar 13];41(4):373-379. Available from: https://pubmed.ncbi.nlm.nih.gov/20832967/

Winstead M, Weaver KJ, Haney GT. Droperidol in the Management of Phantom Limb Pain: Case Report. Clin Pract Cases Emerg Med [Internet]. 2023 May [cited 2024 Mar 13];7(2):115-118. Available from: https://pubmed.ncbi.nlm.nih.gov/37285490/

Indication: Cannabinoid Hyperemesis Syndrome and Gastroparesis

Droperidol on Prevention of Emesis from Cannabinoid Hyperemesis Syndrome (DOPE Study). Ann Emerg Med. 2022 Oct 1;80(4)–S15.

Lee C, Greene SL, Williams A. The utility of droperidol in the treatment of cannabinoid hyperemesis syndrome. Clin Toxicol [Internet]. 2019 Sep [cited 2024 Mar 13];57(9):755-759. Available from: https://pubmed.ncbi.nlm.nih.gov/30729854/

Stirrup N, Greisbach J, Allen J, Ledford Z. Droperidol undermining gastroparesis symptoms (DRUGS) in the emergency department. Am J Emerg Med [Internet]. 2024 Jan [cited 2024 Mar 13];75:142-146. Available from: https://pubmed.ncbi.nlm.nih.gov/37897920/