Frankly, give 'em 10-20 minutes, and whatever antipsychotic you give (if a decent enough dose) will knock most people down, IMHO. Patients were randomly assigned to receive intramuscular injections of lorazepam (2 mg), haloperidol (5 mg), or both in combination. The clinical response produced by high-dose haloperidol was not enhanced by adding either lithium or lorazepam. Patients in each treatment group received 1 to 6 injections of the same study drug within 12 hours, based on clinical need. I've never used it myself; I tend to go with the old 5250 (Haldol 5, Ativan 2, Benadryl 50), but have also used Zyprexa 10 mg IM. To prepare and serve a B52=Haldol and Ativan in one syringe, Benadryl in another. Ativan is compatible with Haldol, ok to mix. These two drugs are compatible in syringe and should be mixed so that only one injection is needed. use labetalol 10 mg or sodium nitroprusside. Haldol 5mg Benadryl 25mg Fentanyl 5mg Haldol 5mg Benadryl 25mg ativan 1mg Ketamine 250mg Versed 4mg These drugs were all administered "iv push" in two or three different syringes over a period of about 30 minutes. There were also … So I remember my instructor mentioning something that he referred to as a "B52 cocktail" awhile back, it's supposedly used as a chemical restraint. Compatibility is unknown between Benadryl and Ativan, do not mix. A topical gel made from a combination of lorazepam (Ativan®), diphenhydramine (Benadryl®), and haloperidol (Haldol®) that is typically applied to the volar surface of the wrist. Need a friendly reminder of a sedation cocktail you can mix up in one syringe? The widespread use of haloperidol and lorazepam in the ED for all chemical restraint is multifactorial. All treatment effects emerged by the fourth day of treatment and persisted. Because of the possibility of a dystonic reaction to IM Haldol, some practitioners give Benadryl 50mg IM at the same time as the Haldol. It has been studied in the treatment of nausea and vomiting related to chemotherapy. They were evaluated hourly after the first injection until at least 12 hours after the last. Many providers at my institution add 50 mg of diphenhydramine to the syringe, and call the combination a “B-52” for Benadryl + 5 mg haloperidol + 2 mg lorazepam. I can't quite remember what the mixture of meds was though, I think it was 5 mg Haldol, 2 mg of Ativan and 50 mg of diphenhydramine… However, there are no studies of absorption, a prerequisite for effectiveness. Together, haloperidol and lorazepam block dopaminergic transmission and enhance GABA receptor binding to reduce agitation quickly – usually within 30 minutes. I do not do this for the following reasons: The dystonic reactions from Haldol tend to occur the day following the IM injection. Look no further... NEW EMS B52 Patch...3" diameter...hook and loop back Lorazepam did not improve the outcome for the patients receiving low-dose haloperidol. haldol, ativan, benadryl( the B52- bendaryl 25/haldol 5/ativan 2) if you need meds to control bp in someone on cocaine don't use a pure beta blocker because then they get unopposed alpha stimulation. (Haldol) +/- Lorazepam (Ativan) SEE OPPOSITE PAGE FOR MEDICATION DOSING Unknown etiology with mild agitation or verbal aggression Utilize behavioral and environmental strategies to deescalate Unknown etiology with moderate agitation or aggression against objects D ip h en yd ram (B)o Lorazepam (Ativan) or Olanzapine (Zyprexa) Lorazepam (Ativan), diphenhydramine (Benadryl), haloperidol (Haldol) (“ABH”) topical gel is currently widely used for nausea in hospice due to perceived efficacy and low cost, and has been suggested for cancer chemotherapy. Benadryl is so short acting that it is gone by then. 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