Anyone still using inapsine?

[MmacFN]

Hey all


Just wondering if anyone is still using this drug in their anesthesia practice?

[RN29306]

Checked with OR pharmacist...not even on formulary.

So no. Never seen it used at other facilities either.

[WickedNurseRed]

We do use Droperidol (generic) 0.625 mg IV x 1 for PONV if the Zofran doesn't do the trick. Our medical director loathes phenergan and we rarely ever use it.

[Idaho-RN]

I used it once several years ago as a nurse, but mind you I was practicing in Easetern Idaho, ha ha!!!

[LouCRNA]

Several hospitals where I did rotations still use it. I don't usually use it routinely, but will use it with someone who has a history of PONV as one of several drugs I'll give to hopefully fend that off. In that case I usually give it right after induction. In the small dose that we're giving, I've never seen it cause prolongation of the QT.

[jwk]

Much ado about nothing, but sadly it's not even on formulary so we don't use it. If I had it I would.

At least ondansetron is off-patent now with a generic available.

[NursePink]

I used it at one hospital. Tried to get it on board with the ENT cases. Pt was required to stay in PACU until 3 hrs after the drug was given. Great drug... such a shame!

[MmacFN]

I like the drug

I use it alot on ppl who are both anxious and nauseated (alot of my current pts).

[AmiK25]

Where I train, we still use it occasionally. We use it for PONV prophylaxis and a couple CRNAs will still use it will Fentanyl for awake fiberoptics....I agree it is a good drug with a bad rap for side effects that occur at high doses!

[deepz]

..... a good drug with a bad rap for side effects that occur at high doses!


Exactly.

Seems like the past decade or so has seen a lot of CHEAP drugs -- drugs that have around forever -- get black-boxed on the basis of oddball isolated case reports.

Makes me suspicious that there might be skullduggery in the pharmaceutical industry. I'm shocked -- shocked, I tell you!

[MmacFN]

Now Deepz

Have you not seen the commercials the pharm industry puts out with ppl who were saved by drugs? ehheh :pound:

They forget to mention that treatments make money, cures do not.


Exactly.

Seems like the past decade or so has seen a lot of CHEAP drugs -- drugs that have around forever -- get black-boxed on the basis of oddball isolated case reports.

Makes me suspicious that there might be skullduggery in the pharmaceutical industry. I'm shocked -- shocked, I tell you!

[dgd611]

At the clinical site that I am currently at, I use it frequently. Each week, we provide anesthesia for mentally retarted patients who need dental scaling, extractions, etc who each get a dose of DIRTA (Decadron 4mg, Inapsine 0.625mg, Robinul 0.2mg, Toradol 30 mg if plt # adequate, and Ancef 1 gm if no PCN allergy). This is all mixed in a 100ml NS bag and given preop. Pts respond wonderfully in PACU (considering preop function).

[DebbieC]

Do you actually mean that I can't trust Big Pharma totally????!!!!????

I was so impressed by how kind the drug companies were when I learned that that newest N&V drug, which is the last resort for chemo N&V, would have cost us something like $2500 for a month's supply, 30 pills, when my husband was getting chemo.....kind of makes you get all choked up....

[vigilent1]

Use it always if hx of ponv. We are given Kytril here and it doesn't work well unless given upfront in > .5mg dose....the pharmacist says .1 OK but I have not seen it work well at all. I use the inapsine also wth OB once baby out.......works great! I have not seen one adverse affect with it if given in .625mg dose or less.......I don't know the cost but I love the drug.

[deepz]

In the December AANA Journal there is a abstract (p.458) of a poster from Mayo on this subject. They conclude that the FDA black box was unnecessary.

[CarolynM]

We are still using droperidol in 0.625mg doses right after induction in patients with a high suspicion for PONV. Mostly plastic surgery/ GYN patients.:usa:

[athomas91]

i love droperidol - but they don't carry it where i work currently... apparently from what i have read - it can now be used but a patient must have a 12 lead done prior to and must be monitored for it's duration of action...
on a personal not - i have been in the ER a few times in the past (i am a puker by nature... :) ) - they have tried EVERYTHING... 0.625 of droperidol is the only thing that ever worked even though i was out for almost 24 hours after... love that stuff.