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A retrospective review of intramuscular olanzapine and parenteral benzodiazepine coadministration in the emergency department.
- Source :
-
The mental health clinician [Ment Health Clin] 2024 Oct 01; Vol. 14 (5), pp. 280-285. Date of Electronic Publication: 2024 Oct 01 (Print Publication: 2024). - Publication Year :
- 2024
-
Abstract
- Introduction: Acute agitation is a common presenting symptom in medical and mental health emergencies that may require pharmacologic intervention. There is a manufacturer recommendation against intramuscular coadministration of olanzapine with parenteral (intramuscular or intravenous) benzodiazepines despite a deficiency of high-quality evidence. The purpose of this study was to contribute to available literature regarding intramuscular olanzapine and parenteral benzodiazepine use in acutely agitated patients in the emergency department (ED).<br />Methods: This was a single-center retrospective chart review of adult ED patients who received intramuscular olanzapine and a parenteral benzodiazepine within 2 hours. The composite primary endpoint evaluated the occurrence of cardiac or respiratory compromise within 2 hours of medication administration. Secondary endpoints mirrored the primary endpoint within 30 minutes and evaluated the occurrence of cardiac arrest or desaturation in the ED outside the 2-hour window.<br />Results: One hundred eleven patients were included in the analysis, 64 (57.7%) of whom had documented vitals or oxygen status within 2 hours of medication administration. The composite primary endpoint occurred in 8 patients (12.5%), with only 1 patient requiring intervention with intravenous fluids. The secondary composite endpoint occurred in 2 (9.5%) of 21 patients with documented vitals or oxygen status within 30 minutes of treatment, neither of which required intervention. There were no identified events of intubation or significant cardiac events.<br />Discussion: Until better evidence is available, this combination therapy should, at minimum, include appropriate patient monitoring. Future studies should investigate risk factors for serious adverse effects.<br /> (© 2024 AAPP. The Mental Health Clinician is a publication of the American Association of Psychiatric Pharmacists.)
Details
- Language :
- English
- ISSN :
- 2168-9709
- Volume :
- 14
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The mental health clinician
- Publication Type :
- Academic Journal
- Accession number :
- 39371484
- Full Text :
- https://doi.org/10.9740/mhc.2024.10.280