title: Pharmacologic management of acutely agitated pediatric patients.
abstract: Acute agitation is a state of behavioral dyscontrol that requires intervention. Medications available in rapid delivery formats are frequently administered to treat acute agitation, either as a chemical restraint or on a voluntary basis. Prior to initiating treatment, the etiology of agitation must be evaluated. In choosing a medication, general pharmacologic principles should be followed. Medication should be selected based on the underlying cause in conjunction with weighing the risks, benefits, and side effects of medications. There are three classes of medications administered to children and adolescents to treat agitation: antihistamines, benzodiazepines, and antipsychotics. The most concerning short-term side effects of antipsychotics are their adverse neurologic effects, neuroleptic malignant syndrome, and prolonged corrected QT interval. Compared with typical antipsychotics, atypical antipsychotics have a more favorable short-term side effect profile.
authors.affiliation: Division of Child and Adolescent Psychiatry, Child and Adolescent Forensic Psychiatry Service, University of Cincinnati/Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. lori.sonnier@cchmc.org
authors.forename: Loretta
authors.initials: L
authors.lastname: Sonnier
authors.forename: Drew
authors.initials: D
authors.lastname: Barzman
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001526:Behavioral Symptoms / Q000188:drug therapy* / Q000209:etiology; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D006633:Histamine Antagonists / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D011595:Psychomotor Agitation / Q000188:drug therapy* / Q000209:etiology
chemical_list: D014150:Antipsychotic Agents; D006633:Histamine Antagonists; D001569:Benzodiazepines