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Pharmacy & Acute Care University
Pharmacy & Acute Care University
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Management of Acute Agitation in the Emergency Department

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  1. Background
  2. Evaluation
  3. Management
    Non-Pharmacologic Management
  4. Benzodiazepines
  5. First Generation Antipsychotics
  6. Second Generation Antipsychotics
  7. Disease State Considerations
  8. Droperidol
  9. Ketamine

Participants 125

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Management of Acute Agitation in the Emergency Department Disease State Considerations
Lesson 7 of 9
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Disease State Considerations

Jimmy October 25, 2021
  • Elderly 🡪 Low-dose SGA d/t minimal QTc effects
    • Caution – benzodiazepines
      • Prolonged sedation, paradoxical agitation, deliriogenic
    • Caution – first-generation antipsychotic
      • With anticholinergic, can exacerbate constipation/urinary retention and worsen agitation 
  • Dementia 🡪 SGA or benzodiazepine
    • Caution – first-generation antipsychotic
      • If dementia related to Parkinson’s disease, can worsen symptoms
  • Alcohol 🡪 FGA or SGA
    • Caution – benzodiazepines
      • Concurrent respiratory depression
  • Psychiatric illness 🡪 SGA
    • Addresses psychosis and underlying disease state
  • Drug intoxication/withdrawal 🡪 benzodiazepine or FGA/SGA
    • Differentiate between agitation d/t EtOH intoxication or withdrawal

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