Contributor: Nick Tsipis, MD

Educational Pearls:

• Prospective trial studied 5 mg IM droperidol to 10 mg IM olanzapine (Zyprexa) in the reducing levels of agitation
• Time to adequate sedation was about 16 minutes for both agents
• Droperidol was slightly less sedating than olanzapine and length of stay for olanzapine was longer
• Olanzapine had a higher rate of requiring another agent for adequate sedation
• Droperidol had a higher rate of adverse events (mainly extrapyramidal symptoms) than olanzapine
• Remember to put the safety of the staff and patient at the forefront of sedation practices and be cognizant of the psychological effect of giving involuntary medications to patients

References

Cole JB, Stang JL, DeVries PA, Martel ML, Miner JR, Driver BE. A Prospective Study of Intramuscular Droperidol or Olanzapine for Acute Agitation in the Emergency Department: A Natural Experiment Owing to Drug Shortages. Ann Emerg Med. 2021;78(2):274-286. doi:10.1016/j.annemergmed.2021.01.005

Summarized by John Spartz, MS4 | Edited by Erik Verzemnieks, MD

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