Haloperidol

Question 1

Haloperidol Class

Answer 1

• High-potency antipsychotic

* Major tranquilizer

Question 2

Haloperidol Action

Answer 2

• Blocks postsynaptic dopamine receptors (D2) in the mesolimbic system (associated with mood and behavior).
• The decrease in dopamine neurotransmission has been found to correlate with the antipsychotic effects.
• Haloperidol possesses extremely weak anticholinergic and alpha-adrenergic receptor blocking effects.

Question 3

Haloperidol Indications

Answer 3

• Acute Psychosis (Consideration for patient and rescuer safety)

Question 4

Haloperidol Contraindications

Answer 4

• Coma
• Severe toxic CNS depression
• Parkinson’s disease (dopamine blockade can dramatically worsen the condition)

Question 5

Haloperidol Precautions

Answer 5

• Severe cardiovascular disorders (EKG monitoring is recommended in these patients)
• Pregnancy (C)
• Seizure disorder (slight lowering of seizure threshold)
• Elderly patients may require reduce dosage

Question 6

Haloperidol Dosage

Answer 6

• Adults: 5-10 mg IV or IM max dose 20 mg (reduce dosage to 0.5 to 2 mg in geriatrics)
• Pediatrics: 0.5 mg IM. Children 6-12 years of age: 1-3 mg IV or IM (may not be recommended for chilren)

Question 7

Haloperidol Onset/ Duration

Answer 7

• Onset: IM—10-20 minutes. Not approved for IV use by FDA.

* Duration: 12-24 hours

Question 8

Haloperidol Side Effects

Answer 8

• Extrapyramidal reactions
• Neuroleptic malignant syndrome (hyperthermia, severe extrapyramidal dysfunction, alterations in consciousness, altered mental status, and autonomic instability)
• Orthostatic hypotension
• Insomnia, restlessness
• Sedation
• Seizures
• Respiratory depression
• Tachycardia
• Anticholinergic effects

Question 9

Haloperidol Interactions

Answer 9

• Additive effects—may induce hypotension in patients taking antihypertensives.
• May decrease the activity of warfarin
• Patients taking lithium may develop encephalopathic syndrome