Intramuscular Treatment of Behavioral Emergencies by stephan2

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									                     Treatment of Behavioral Emergencies
                      Intramuscular Short-Acting Agents


    MEDICATION             MAX SINGLE             MINIMUM               MAX TOTAL DOSE
                           DOSE (MG)           INTERVAL (HRS)            PER DAY (MG)
     IM Aripiprazole1          15                     2                        30
  IM Chlorpromazine2          100*                    2                       400
IM Diphenhydramine3-4         100                     1                       400
   IM Fluphenazine4-5          10                     1                        20
     IM Haloperidol2           10                     1                        40
    IM Hydroxyzine3           100                     1                       400
    IM Lorazepam2,6             4                     1                        12
     IM Olanzapine7            10                     2                        30
     IM Ziprasidone8           20                     2                        40
      *Initial dose is not recommended to be greater than 50mg if tolerability is unknown

      1. Product Information: Abilify®, aripirpazole injection. Bristol-Myers Squibb,
         Princeton, NJ, 2007.
      2. Allen MH, Currier GW, Carpenter D, et al. Treatment of Behavioral
         Emergencies Expert Consensus Guideline Series. Journal of Psychiatric
         Practice 2005;11 [Suppl 1]:1-108.
      3. Lacy CF, Armstrong LL, Goldman MP, Lance LL (2008). Drug Information
         Handbook (16 th ed.). Hudson, Ohio: Lexi-Comp.
      4. DRUGDEX® System [intranet database]. Version 5.1. Greenwood Village,
         Colo: Thomson Healthcare.
      5. Product Information: Fluphenazine hydrochloride injection. Abraxis
         Pharmaceutical Products, Schaumburg, IL, 2006.
      6. Lukens TW, Wolf SJ, Edlow JA, et al. Clinical Policy: Critical Issues in the
         Diagnosis and Management of the Adult Psychiatric Patient in the
         Emergency Department. From the American College of Emergency
         Physicians Clinical Policies Subcommittee (Writing Committee) on Critical
         Issues in the Diagnosis and Management of the Adult Psychiatric Patient
         in the Emergency Department. Ann Emerg Med 2006;47:79-99.
      7. Product Information: Zyprexa®, olanzapine intramuscular injection. Eli Lilly
         and Company, Indianapolis, IN, USA, 2008.
      8. Product Information: GEODON® ziprasidone mesylate IM injection.
         Pfizer,Inc, New York, NY, 2007.




                                                                                    05-14-08

								
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