Podcast 601: Droperidol

<p><strong>Contributor: Sam Killian, MD</strong></p> <p><strong>Educational Pearls:</strong></p> <ul> <li style="font-weight: 400;"><span style= "font-weight: 400;">Droperidol (Inapsine) is an antipsychotic drug with efficacy for  nausea, vomiting, headaches, and treating agitation</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">In the early 2000’s, Droperidol received a black box warning for QT prolongation</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">This caused a precipitous drop of in administration and ultimately led to a stop in production</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">More careful analysis since has called into question the true incidence of QT prolongation in typical dosing</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Retrospective review published this year looked at 15,374 non-critical and 1,172 critical patients who received droperidol with only a single episode of Torsades des pointes (which was attributed to multiple other risk factors)</span></li> <li style="font-weight: 400;"><span style="font-weight: 400;">Of the 2,431 non-critical patients, and 396 critical patients, who received an ECG before and after administration, there were no changes to the mean QTc</span></li> <li style="font-weight: 400;"><span style= "font-weight: 400;">Droperidol is being manufactured again and the prior black box warning being called into question, so it will likely begin to become more widely available for use</span></li> </ul> <p><strong>References</strong></p> <p><span style="font-size: 10pt;"><span style= "font-weight: 400;">Cole JB, Lee SC, Martel ML, Smith SW, Biros MH, Miner JR.</span> <a href= "https://pubmed.ncbi.nlm.nih.gov/32726229/"><span style= "font-weight: 400;">The Incidence of QT Prolongation and Torsades des Pointes in Patients Receiving Droperidol in an Urban Emergency Department.</span></a> <span style="font-weight: 400;">West J Emerg Med. 2020 Jul 2;21(4):728-736. doi: 1