Emergency Psychiatric Medications - page 2

Could someone tell me the most common medications used for psychiatric emergencies? I am guessing most of them are IM but the information I have found has been from a drug company or wikipedia and... Read More

  1. by   CapeCodMermaid
    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. by   Hygiene Queen
    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".

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    Good luck with your interview!
    Psych is awesome.
  3. by   That Guy
    Z52 is my favorite. Zyprexa Benadryl and Ativan
  4. by   jmdRN
    we do B-52's here on our agitated pts in the ER. Benadryl, 5mg Haldol and 2mg Ativan
  5. by   mikenmim
    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. by   Meriwhen
    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. by   TerpGal02
    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. by   kingjulz29
    Most commonly used on my unit is Haldol 5mg with Ativan 2mg. IM along with Cogentin 1mg IM for EPS
  9. by   livert24
    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. by   Quit Floating Me
    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. by   gatigress
    we use Haldol/ Ativan or Zyprexa/ Ativan depending on the doctors preference..
  12. by   Mandychelle79
    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. by   Abug
    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