Drug Summary

Ziprasidone (Geodon®)

Pharmacologic properties:

Geodon is an atypical anti-psychotic and tranquilizing agent with multiple mechanisms of action. The drug is an antagonist at dopamine D2, serotonin 5HT1D and 5HT2A receptors, and an agonist at serotonin (5HT1A) receptors. Geodon also moderately inhibits re-uptake of norepinephrine and serotonin and has anti-histamine activity. This drug has fewer documented side effects - including extrapyramidal symptoms - than typical antipsychotics such as haloperidol.

Indications:

  • Behavioral emergencies for patients with severe agitation or aggressive behavior resulting in interference with patient care or patient/crew safety.

Contraindications:

  • Not to be administered to patients with Dementia-related psychosis
  • Documented hypersensitivity
  • Documented Long-QT syndrome

Precautions:

  • Prolongs QT/QTc – use caution in patients with known risk factors (hypomagnesemia, hypokalemia, use of other drugs that prolong QT/QTc)
  • May induce hyperglycemia – monitor glucose in high risk patients
  • May cause drug-induced leukopenia/neutropenia

Adverse Reactions:

  • Extrapyramidal symptoms (dystonic reactions)
  • Somnolence
  • Dizziness
  • Headache
  • Orthostatic Hypotension
  • EKG changes (prolong QTc)
  • Rash
  • Nausea and vomiting

Dosage and administration:

  • Adult
    • 10 mg IM if < 60 kg
    • 20 mg IM if ≥ 60 kg
  • Pediatric
    • Safety and effectiveness in children has not been conducted for IM route