Haloperidol - a butyrophenone with longer duration of action than droperidol. It has anti-emetic and neuroleptic effects with minimal cardiovascular and respiratory effects. It is a mild a-blocker and may cause hypotension in the presence of hypovolaemia.
Uses
Acute agitation and delirium
Contraindications
QT prolongation, torsades de pointe, ventricular arrhythmias, agitation caused by hypoxia, hypokalaemia or a full bladder
Parkinson’s disease
Administration
• IV bolus: 2.5–5mg
• IV infusion: 30 mg in 50 ml of glucose 5% at a rate of 0–10 mg/h
• IM: 5–10mg
Up to every 4–8 h
How not to use haloperidol
Hypotension resulting from haloperidol should not be treated with adrenaline as a further decrease in BP may result
Adverse effects
Extra-pyramidal movements
Neuroleptic malignant syndrome (treat with dantrolene)
Prolongation of QT interval
Cautions
Concurrent use of other CNS depressants (enhanced sedation)
Organ failure
CNS: sedative effects increased
Hepatic: can precipitate coma
Renal: increased cerebral sensitivity
Renal replacement therapy
No further dose modification is required during renal replacement therapy
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