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Haloperidol 💊
⚠️ Use reduced doses in elderly and frail patients.
🚫 Avoid in: Lewy body dementia, Parkinsonism, prolonged QTc >470 ms, acute alcohol withdrawal, epilepsy.
💡 Non-drug strategies first: orient the patient (well-lit room, visible clock), involve family, reassurance.
📘 About
- Haloperidol is a typical antipsychotic (neuroleptic).
- Main uses: acute confusion (delirium), acute psychosis, mania, severe agitation, nausea/vomiting.
⚙️ Mode of Action
- Dopamine D2 receptor antagonist in mesolimbic pathways.
- Reduces positive psychotic symptoms, agitation, and vomiting reflex (chemoreceptor trigger zone).
- But also blocks nigrostriatal dopamine → extrapyramidal side effects (EPS).
💊 Indications & Example Doses
- 🤢 Severe Nausea/Vomiting: 1–2 mg IM.
- 🧓 Agitation in elderly (delirium): 0.5–1.5 mg PO/IM every 8–12h.
- 🌀 Acute Psychosis/Mania: 0.5–3 mg PO/IM tds (max 20 mg/day).
- 😟 Severe Anxiety (short-term): 0.5 mg PO every 8–12h.
- 🚨 Severely Disturbed Patients: 2–10 mg PO/IM initially, titrate up to 18 mg/day.
⚠️ Always check ECG (QTc) before initiation and review renal/hepatic function.
🚫 Contraindications
- Parkinson’s disease, Lewy body dementia.
- Prolonged QTc (>470 ms), history of arrhythmia.
- Liver or renal failure.
- Epilepsy, acute alcohol withdrawal, severe depression.
- Myasthenia gravis.
⚠️ Side Effects
- 🧠 Extrapyramidal symptoms (rigidity, tremor, akathisia, dystonias).
- 🚨 Neuroleptic Malignant Syndrome (rare, life-threatening).
- 💤 Sedation, drowsiness, insomnia.
- 📉 Hypotension, dizziness, prolonged QT.
- 👁️ Glaucoma, blurred vision.
- GI upset, antimuscarinic effects (dry mouth, constipation, urinary retention).
📖 References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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