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Section 8 - MEDICATION GUIDELINES

SEDATIVE / HYPNOTICS / ANTIPSYCHOTIC

Ziprasidone (GEODON) / Antipsychotic

DESCRIPTION

  • An atypical antipsychotic acting as a dopamine antagonist that also affects other neurotransmitters to reduce psychosis and acute agitation.

INDICATIONS

  • Used for the control of acute agitation in schizophrenic and/or severely agitated patients.

CONTRAINDICATIONS

  • Persons known to have prolonged QTc intervals
    • Only in high doses of 40-60 mg has shown a slight increase in QTc
  • Known recent acute myocardial infarction
  • Uncompensated heart failure
  • Patients known to take other medications that also prolong the QTc interval
  • Hypersensitivity to the medication.

PRECAUTIONS

  • No clinically significant drug-drug interactions have been identified with other concomitantly administered EMS medications such as benzodiazepines.

DOSAGE

  • 10 - 20 IM for adults based on the BARS scale for agitation.
  • Not approved for use in pediatric patients.

ONSET OF ACTION

  • Less than 15 minutes
  • Peak effect 20-30 minutes
  • Half-Life 2-5 hours


Behavioral Activity Rating Scale

7 Violent, requires restraint.
6 Extremely/continually active; not requiring restraint.
5 Signs of overt (physical or verbal) activity; calms down with instruction.
4 Quiet and awake (normal activity level).
3 Drowsy, appears sedated.
2 Asleep, but responds normally to verbal or physical contact.
1 Difficult or unable to arouse.


Medications known to prolong the QTc (This table is not all inclusive)

Adderall Droperidol Procainamide
Amiodarone Effexor Propulsid
Anzemet Elavil Prozac
Avelox Erythromycin Seroquel
Betapace Haldol Tamoxifen
Cardene Lozol Zanaflex
Cerebyx Mellaril Zithromax
Detrol LA Norpace Zoloft