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dc.contributor.authorJeffers, Trevor
dc.contributor.authorDarling, Brenna
dc.contributor.authorEdwards, Christopher
dc.contributor.authorVadiei, Nina
dc.date.accessioned2022-04-07T18:00:41Z
dc.date.available2022-04-07T18:00:41Z
dc.date.issued2022-03
dc.identifier.citationJeffers, T., Darling, B., Edwards, C., & Vadiei, N. (2022). Efficacy of Combination Haloperidol, Lorazepam, and Diphenhydramine vs. Combination Haloperidol and Lorazepam in the Treatment of Acute Agitation: A Multicenter Retrospective Cohort Study. Journal of Emergency Medicine.en_US
dc.identifier.issn0736-4679
dc.identifier.doi10.1016/j.jemermed.2022.01.009
dc.identifier.urihttp://hdl.handle.net/10150/663898
dc.description.abstractBackground: Antipsychotic and sedative combinations are commonly used for treating agitation in the emergency department despite limited evidence regarding their comparative safety and efficacy. Objectives: To compare the efficacy and safety of combination haloperidol, lorazepam, and diphenhydramine (B52) to combination haloperidol and lorazepam (52) in treating acute agitation. Methods: This multicenter, retrospective cohort study included adult patients ≥ 18 years of age who received either B52 or 52 at a Banner Health facility between August 2017 and September 2020. Patients were excluded if they had a pre-existing movement disorder or were withdrawing from alcohol. The primary outcome was administration of additional agitation medication(s) within 2 h of B52 or 52. Secondary outcomes included incidence of extrapyramidal symptoms, length of stay, and additional safety measures. Results: There was no difference in administration frequency of additional agitation medication(s) (B52: n = 28 [14%] vs. 52: n = 40 [20%]; p = 0.11). Patients who received 52 were more likely to require an antimuscarinic medication within 2 days (15 vs. 6 patients, p = 0.04). Of the patients who received an antimuscarinic medication, none had documented extrapyramidal symptoms. The 52 group had shorter length of stay (13.8 vs. 17 h; p = 0.03), lower incidence of hypotension (7 vs. 32 patients; p < 0.001), and oxygen desaturation (0 vs. 6 patients; p = 0.01), and fewer physical restraints (53 vs. 86 patients; p = 0.001) compared with the B52 group. Conclusions: Both the B52 and 52 combinations infrequently required repeat agitation medication; however, the B52 combination resulted in more oxygen desaturation, hypotension, physical restraint use, and longer length of stay.en_US
dc.language.isoenen_US
dc.publisherElsevier BVen_US
dc.rights© 2022 Published by Elsevier Inc.en_US
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/en_US
dc.subject52en_US
dc.subjectagitationen_US
dc.subjectantipsychoticen_US
dc.subjectB52en_US
dc.subjectbenzodiazepineen_US
dc.subjectefficacyen_US
dc.subjectemergency departmenten_US
dc.subjectextrapyramidal symptomsen_US
dc.subjectpharmacotherapyen_US
dc.subjectsafetyen_US
dc.titleEfficacy of Combination Haloperidol, Lorazepam, and Diphenhydramine vs. Combination Haloperidol and Lorazepam in the Treatment of Acute Agitation: A Multicenter Retrospective Cohort Studyen_US
dc.typeArticleen_US
dc.contributor.departmentDepartment of Pharmacy Practice and Science, University of Arizona College of Pharmacyen_US
dc.contributor.departmentDepartment of Emergency Medicine, University of Arizona College of Medicineen_US
dc.contributor.departmentDepartment of Psychiatry, University of Arizona College of Medicineen_US
dc.identifier.journalJournal of Emergency Medicineen_US
dc.description.note12 month embargo; available online: 12 March 2022en_US
dc.description.collectioninformationThis item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.en_US
dc.eprint.versionFinal accepted manuscripten_US
dc.identifier.piiS0736467922000579
dc.source.journaltitleThe Journal of Emergency Medicine


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