Emergency Psychiatric Medications - page 2

1. 
   Apr 29, '13

   It's uncommon to get EPS from one dose of an antipsychotic, so if it's only being used on an emergency basis, cogentin most likely wouldn't be needed.
   IM Haldol.
2. 
   Apr 29, '13

   Often times, you will have a choice of a PO emergency med and an IM of the same med.
   So, the goal is to attempt to have the pt take the PO first, then if that fails, you go with the IM.
   Better to try and get the PO before things get too out-of-hand than having to do an IM, because usually by that time that means the pt has possibly escalated to the point of needing to be held down by staff... we like to try to avoid that.
   In fact, good staff will do everything they can to try to redirect a pt to avoid having to use any emergency meds.
   We use a lot of Haldol and Ativan. They can be given together in a single syringe-- hence it's known as "the cocktail".
   
   P.S.
   If you haven't figured it out already, if you want to reply to a specific post, hit the "quote" button and then type your response. It avoids confusion, making it clear who you are responding to.
   
   Good luck with your interview!
   Psych is awesome.
3. 
   Apr 29, '13

   Z52 is my favorite. Zyprexa Benadryl and Ativan
4. 
   Apr 30, '13

   we do B-52's here on our agitated pts in the ER. Benadryl, 5mg Haldol and 2mg Ativan
5. 
   Apr 30, '13

   We always used HA HA therapy. Haldol (5 or 10) and Ativan (2). Repeat in an hour if needed. Of course, if you can head off the emergency and your patient agrees to take po meds then everybody wins. My preferred po med is Haldol or Thorazine.
6. 
   Apr 30, '13

   Quote from mikenmim

   Of course, if you can head off the emergency and your patient agrees to take po meds then everybody wins. My preferred po med is Haldol or Thorazine.

   If they're willing to go PO, we'll do the B52s in PO form. Or we'll go with Zydis and a benzo.
7. 
   May 2, '13

   Our go to for IMs is Geodon and Ativan. Sometimes Zyprexa. If we can get them to take something PO, usually 5 of Zydis and Xanax or Ativan.
8. 
   May 4, '13

   Most commonly used on my unit is Haldol 5mg with Ativan 2mg. IM along with Cogentin 1mg IM for EPS
9. 
   May 4, '13

   5 Haldol 2 Ativan is the most common combo I've seen. And as you stated always something to control the EPS. I was speaking with a coworker the other day who is a long time psych nurse at a particular hospital, so she is familiar with a lot of the patients. She told me one particular patient has actually built up the tolerance to normally receive 40mg Haldol!! Just thought that was interesting. I'm looking into becoming a Psych NP and I just don't think I would be comfortable prescribing that much medication to anybody.
10. 
    May 9, '13

    For emergency situations (depends on which doctor is covering) 25 or 50mg Benadryl, 2mg Ativan and 5 or 10mg Haldol are given (in the same syringe) IM.
11. 
    May 9, '13

    we use Haldol/ Ativan or Zyprexa/ Ativan depending on the doctors preference..
12. 
    May 9, '13

    If it is our normal psych doctor giving the orders, Haldol and Ativan most of the time. If we called a violent code, depends on what the doctor orders when they get there ( hospitalist)
13. 
    May 14, '13

    OK, great info. Has anyone but me seen Geodon used in emergent situations? It can be helpful but must be given with food. That can be tricky with a paranoid person. But if the person's willing to take a po it seems to be quite effective and sure doesn't have the SEs of vitamin H.

    Last edit by Abug on May 14, '13

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