40 Questions
Which patient population should droperidol be avoided in?
All of the above
How does the concomitant administration of phenothiazines affect the ventilatory effects of opioids?
The ventilatory effects of opioids are exaggerated
What adverse effect of droperidol is mentioned in the text?
Increased incidence of hypotension
Which of the following is recommended when using phenothiazines in the perioperative setting?
Use glycopyrrolate if an anticholinergic agent is needed
How does the concomitant administration of phenothiazines and opioids affect the analgesic effects of the opioids?
The analgesic effects of opioids are potentiated
Which of the following best describes the proposed mechanism of action of antidepressants?
Inhibition of neurotransmitter reuptake
Which of the following adverse effects is most commonly associated with droperidol?
Postoperative hallucinatory episodes
In neuroleptanalgesia, which neurotransmitter does droperidol primarily block at the carotid body to augment the ventilatory response?
Dopamine
Which of the following statements regarding droperidol-fentanyl combination therapy is TRUE?
It is not associated with enhanced ventilatory depression compared to either drug alone
Which of the following adverse effects has been reported when droperidol is given to pheochromocytoma patients?
Hypertension
What rare adverse effect can occur at low or high doses of droperidol, as indicated by a black-box warning?
QT interval prolongation and/or torsade de pointes
When combined with droperidol, which type of drugs generally have additive or potentiating effects, leading to CNS depression?
Central Nervous System (CNS) depressant drugs
What is the primary side effect associated with clozapine use?
Agranulocytosis
What is a common adverse reaction to haloperidol use?
Bronchospasm
Which antipsychotic agent has a high risk of extrapyramidal symptoms (EPS)?
Risperidone
What is the mechanism of action of droperidol in the prevention of nausea and vomiting?
Blocking dopamine receptors in the chemoreceptor trigger zone
Which drug class should be used cautiously with droperidol due to a potential interaction affecting plasma concentrations?
Beta-blockers
What is the primary action of droperidol on the central nervous system?
Producing sedation and tranquilization
Which of the following symptoms is NOT commonly associated with increased prolactin levels?
Venous Thromboembolism
What condition is characterized by ANC levels below 500/mm3?
Leukopenia
Droperidol is safe to use in patients with prolonged QTc interval.
False
Combining droperidol with agents that prolong the QTc interval is safe.
False
Droperidol is recommended for patients with Parkinson's disease.
False
Phenothiazines enhance the effects of CNS depressant drugs like stimulants.
False
The analgesic effects of opioids are decreased when combined with phenothiazines.
False
Phenothiazines are commonly used as anti-emetic agents due to their low incidence of adverse effects.
False
Droperidol and metoclopramide should not be co-administered due to their dopaminergic blockade properties.
True
Using ketamine and meperidine concurrently with phenothiazines is safe.
False
Glycopyrrolate should not be used as an anticholinergic agent when phenothiazines are administered.
False
Phenothiazines are commonly recommended for patients with Parkinson's disease.
False
Droperidol is ______ in patients with prolonged QTc interval.
contraindicated
Droperidol should not be administered to patients with ______ disease.
parkinson's
Do not use droperidol with other agents that also ______ the QTc interval.
prolong
Avoid the use of ______ & meperidine when administering phenothiazines.
ketamine
In general, phenothiazine agents are not used as ______ agents due to their higher incidence of adverse effects.
anti-emetic
What is the primary mechanism of action of droperidol that allows it to be used as an anti-emetic agent?
Droperidol is a potent dopamine antagonist, and its anti-emetic effects are primarily mediated by blocking dopamine receptors in the chemoreceptor trigger zone of the area postrema in the brain.
Explain the contraindication for using droperidol in patients with prolonged QTc interval and the potential consequence of ignoring this contraindication.
Droperidol is contraindicated in patients with prolonged QTc interval (QTc > 440 ms in men, 450 ms in women) due to its potential to further prolong the QTc interval and increase the risk of developing torsades de pointes, a potentially fatal ventricular arrhythmia.
Why is droperidol contraindicated in patients with Parkinson's disease, and what alternative agents could be considered in this patient population?
Droperidol is contraindicated in patients with Parkinson's disease because it is a potent dopamine antagonist, and Parkinson's disease is characterized by a deficiency of dopamine in the central nervous system. Alternative agents that could be considered include other antiemetics like ondansetron or granisetron that do not have dopaminergic effects.
Discuss the potential drug-drug interactions between droperidol and other agents that prolong the QTc interval, and the importance of avoiding such combinations.
Droperidol should not be used concomitantly with other agents that also prolong the QTc interval, as this can lead to an additive or synergistic effect on QTc prolongation, further increasing the risk of developing torsades de pointes and other ventricular arrhythmias. Avoiding such combinations is crucial to mitigate the risk of potentially fatal cardiac complications.
Explain the potential impact of concomitant administration of phenothiazines and opioids on the ventilatory effects and analgesic effects of opioids.
The concomitant administration of phenothiazines and opioids can exaggerate the ventilatory depressant effects of opioids, potentially leading to respiratory depression. Additionally, the analgesic effects of opioids are potentiated when combined with phenothiazines, potentially increasing the risk of opioid-related adverse effects.
Learn about the actions of Droperidol (Inapsine®) which include mild alpha-adrenergic blockade, peripheral vascular dilatation, and reduction of the pressor effect of epinephrine. It can produce hypotension, decreased peripheral vascular resistance, and may decrease pulmonary arterial pressure. Droperidol also causes cerebral vasoconstriction that leads to a decrease in cerebral blood flow without altering resting ventilation or the ventilatory response to CO2.
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