Emergency Psychiatric Medications - page 3

Most commonly used on my unit is Haldol 5mg with Ativan 2mg. IM along with Cogentin 1mg IM for EPS

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.

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.

we use Haldol/ Ativan or Zyprexa/ Ativan depending on the doctors preference..

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)

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.

We use Geodon in emergencies, never PO though, always IM. Then ya get around the take with food thing lol. That seems to be our go to IM these days. It works but takes forEVER to mix.

Geodon IM is used but its more likely the patient will calm down by the time its reconstituted

PO Geodon works well if a patient is willing and able to eat a generously-spread peanut butter sandwich along with it---the peanut butter provides the fat needed for best absorption of the drug. Just a suggestion from someone who actually takes ziprasidone regularly and has learned a few tricks that promote its bioavailability while avoiding weight gain!

Only problem with long term Geodon therapy is the whole long QT thing. I have seen it a few times. Our docs always get a baseline ecg when starting it, and then a repeat a few days later.