Hypotension droperidol

An exception to the relatively safe use of high-potency agents has been noted in the combination of droperidol with the narcotic fentanyl, which can cause marked hypotension (27). 

Intravenous lidocaine has been used to treat severe chronic daily headache in 19 patients (three men, median age 37 years) (9). There were adverse effects during four infusions of lidocaine hyperkalemia (6.4 mmol/1), which did not resolve after withdrawal of lidocaine transient hypotension (75/50 mmHg), which was attributed to concomitant droperidol an unspecified abnormality of cardiac rhythm and on another occasion a transient bradycardia and chest pain with a normal electrocardiogram, fever, and intractable nausea. The study was neither randomized nor placebo-controlled, and in no case was the adverse event strongly associated with the administration of lidocaine. 

Butyrophenones include haloperidol (Haldol) and droperidol (Inapsine). They block dopamine2 receptors in the CTZ. Extrapyramidal side effects (EPS) are likely to occur if these dmgs are used over an extended period of time. Hypotension can also occur. 

A. Haloperidol and droperidol produce less sedation and less hypotension than chlorpromazine but are associated with a higher incidence of extrapyramidal... 

Eight out of 42 patients taking unnamed beta blockers given atracurium developed bradycardia (less than 50 bpm) and hypotension (systolic pressure less than 80 mniHg). Most of them had been premedicated with diazepam, induced with methohexital, and maintained with droperidol, fentanyl and nitrous oxide/oxygen. A further 24 showed bradycardia, associated with hypotension on 9 oeeasions. All responded promptly to 300 to 600 micrograms of intravenous atropine. ... 

The effect of metoclopramide on oral morphine absorption is an established interaction that can be usefully exploited in anaesthetic practice, but the increased sedation may also represent a problem if the morphine is being given long-term. The morphine-sparing effect of droperidol is also a useful interaction, but the increased sedation and possible respiratory depression and hypotension should be borne in mind. One manufacturer of fentanyl specifically warns that concurrent use with droperidol can result in a higher incidence of hypotension. ... 

An Isolated report describes hypotension In a patient given droperidol shortly after the withdrawal of phenelzine. 

The concurrent use of other CNS depressants, including sedatives, hypnotics, general anesthetics, droperidol, phenothiazines or other tranquilizers, or alcohol, increases the risk of respiratory depression, hypotension, profound sedation, or coma. 

Nervous System A systematic review of low-dose use of droperidol as an antiemetic from 25 trials (2957 patients) reported extrapyramidal side effects, increased restlessness and decreased headache [143 ]. A study of use in 144 children at doses of 10 ng/kg reported sedation as the only side effect in 27% [144 ]. The use of low-dose droperidol for the treatment of headaches in the emergency room in 73 patients was associated with two cases of extrapyramidal reaction (restlessness/anxiousness and dystonia) [145 ]. Three of 589 patients experienced extrapyramidal reactions with droperidol infusion for nausea and vomiting [146 ]. Adverse effects occurring in 49 elderly patients treated with droperidol for agitation include hypotension (2), oversedation (2) and hypotension/oversedation (1) [147 ]. A case of an extrapyramidal reaction ataxia/dyskinesia) is reported in a female undergoing laparoscopic cholecystectomy [148 ]. 

---