- Mechanism of Action: Antipsychotic, Antiemetic; antagonizes dopamine and alpha adrenergic receptors.
- Indications: Agitation, nausea/vomiting, headache, pain (as adjunct w/ opiate)
- Contraindications: Allergy to drug/class, known or suspected prolonged QT
- Acute agitation: 5-10mg (IV) or 10 mg (IM)
- Nausea/vomiting: 0.625 – 2.5 mg (IV)
- Onset: 5-10 minutes
- Duration: 2-4 hours
- Adverse Reactions: QT prolongation, extrapyramidal side effects
- Mechanism of Action: Antipsychotic; blocks dopaminergic receptors in the brain, depressing reticular activating system.
- Indications: Acute agitation, psychosis
- Contraindications: Allergy to drug, Parkinson’s disease. Caution in QT prolongation.
- Dosage: 5-10 mg PO/IM/IV q2hrs (Max 100mg/day)
- Onset: 10-20 minutes
- Duration: 4-6 hours (IV)
- Adverse Reactions: Drowsiness, extrapyramidal symptoms, tardive dyskinesia
- Special Considerations: May increase liver function test values
- Mechanism of Action: Atypical antipsychotic; binds to dopamine, histamine, alpha1, and 5HT2 receptors.
- Indications: Acute agitation, schizophrenia, bipolar disorder
- Contraindications: Allergy to drug/class. Should not be given for dementia-related psychosis, NMS
- Dosage: 5-10 mg IM/ODT (max 30mg/day)
- Onset: 15-45 minutes
- Duration: Half life of 30 hours for most adults
- Adverse Reactions: Orthostatic hypotension (3-20%), Neuroleptic malignant syndrome, extrapyramidal side effects
- Special Considerations: N/A
- Mechanism of Action: Antipsychotic; D2 and 5HT2 antagonist. Strong alpha 1 blocker and histamine-1 antagonist.
- Indications: Acute agitation, psychosis.
- Contraindications: QT prolongation, allergy to drug, decompensated heart failure
- Dosage: 10-20mg IM q2-4 hrs (Max: 40 mg/day)
- Duration: Half life 2-7 hrs.
- Adverse Reactions: Prolonged QT, torsades, neuroleptic malignant syndrome, extrapyramidal side effects, dizziness
- Special Considerations: None