Department of Emergency Medicine, Brookdale University Hospital Medical Center, Brooklyn, New York.
Department of Emergency Medicine, Maimonides Medical Center, Brooklyn, New York.
J Emerg Med. 2023 Mar;64(3):289-294. doi: 10.1016/j.jemermed.2022.12.012. Epub 2023 Mar 14.
Droperidol is a butyrophenone, with antiemetic, sedative, anxiolytic, and analgesic properties. Although droperidol was once widely used in both emergency and perioperative settings, use of the medication declined rapidly after a 2001 U.S. Food and Drug Administration (FDA) boxed warning called the medication's safety into question.
The purpose of this clinical review was to provide evidence-based answers to questions about droperidol's safety and to examine its efficacy in its various clinical indications.
Droperidol is an effective sedative, anxiolytic, analgesic, and antiemetic medication. As a sedative, when compared with haloperidol, droperidol has faster onset, as well as greater efficacy, in patients experiencing acute psychosis, with no increase in adverse events. As an antiemetic, droperidol has been found to have equal or greater efficacy in reducing nausea and vomiting than ondansetron and metoclopramide, with similar adverse effects and the added effect of reducing the need for rescue analgesia in these patients. As an analgesic, droperidol is effective for migraines and has opioid-sparing effects when used to treat abdominal pain. Droperidol is a particularly useful adjunct in patients who are opioid-tolerant, whose pain is often difficulty to manage adequately.
Droperidol seems to be effective and safe, despite the boxed warning issued by the FDA. Droperidol is a powerful antiemetic, sedative, anxiolytic, antimigraine, and adjuvant to opioid analgesia and does not require routine screening with electrocardiography when used in low doses in otherwise healthy patients before administration in the emergency department.
氟哌利多是一种丁酰苯类药物，具有止吐、镇静、抗焦虑和镇痛作用。尽管氟哌利多曾广泛用于急诊和围手术期，但在 2001 年美国食品和药物管理局（FDA）发出药物安全性警告后，其使用迅速下降。
本临床综述的目的是提供有关氟哌利多安全性的循证答案，并检查其在各种临床适应症中的疗效。
氟哌利多是一种有效的镇静剂、抗焦虑药、镇痛药和止吐药。作为镇静剂，与氟哌啶醇相比，氟哌利多在急性精神病患者中起效更快，疗效更好，且不良反应无增加。作为止吐药，氟哌利多在减少恶心和呕吐方面的疗效与昂丹司琼和甲氧氯普胺相当或更高，且不良反应相似，并能减少这些患者对抢救性镇痛的需求。作为镇痛药，氟哌利多对偏头痛有效，并具有阿片类药物节约作用，用于治疗腹痛。氟哌利多对于阿片类药物耐受的患者特别有用，这些患者的疼痛往往难以充分控制。
尽管 FDA 发出了药物安全性警告，但氟哌利多似乎仍然有效且安全。氟哌利多是一种有效的止吐药、镇静剂、抗焦虑药、抗偏头痛药，并且在低剂量用于急诊患者时，在没有常规进行心电图筛查的情况下，也可以作为阿片类药物镇痛的辅助药物。
