![]() ![]() Has a more rapid onset and greater efficacy for agitation and is also useful for drug- or toxin-induced nausea and vomiting, but its role in routine therapy is uncertain because of reports of deaths and a “black box” warning about QT prolongation (see Item IV.D below). Is used for the management of acute agitated functional psychosis or extreme agitation induced by stimulants or hallucinogenic drugs, especially when drug-induced agitation has not responded to a benzodiazepine. The serum half-life for olanzapine is 20–54 hours, and for ziprasidone it is 2–5 hours. Both drugs are metabolized principally by the liver. Olanzapine IM results in rapid absorption, with peak levels occurring within 15 to 45 minutes, whereas ziprasidone IM has peak levels occurring at approximately 60 minutes. Olanzapine and ziprasidone are well absorbed from the GI tract and by the intramuscular route. The serum half-life for haloperidol is 12–24 hours. Droperidol has a more predictable and rapid onset of 3–10 minutes, and both have peak pharmacologic effects that occur within 30–40 minutes of an intramuscular injection. ![]() Droperidol is available only for parenteral use and is also well absorbed by the intramuscular route. Haloperidol is well absorbed from the GI tract and by the intramuscular route. Therefore, they have a greater propensity to cause sedation and orthostatic hypotension. However, olanzapine has greater anticholinergic effects, and both have greater antihistaminic and anti–alpha-adrenergic effects. This provides less risk for extrapyramidal side effects. They have weaker and more selective antidopaminergic activity, and a higher ratio of serotonin-to-dopamine antagonism. They have strong central antidopaminergic activity and weak anticholinergic and anti–alpha-adrenergic effects.Īre second-generation or “atypical” antipsychotic agents. Are butyrophenone neuroleptic drugs, often referred to as “first-generation” or “typical” antipsychotics, that are useful for the management of acutely agitated psychotic patients and as antiemetics. ![]()
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