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Haloperidol (Haldol®)
Kevin Collins, MD PhD
For the REMO Medical Advisory Committee
Background
• Acutely agitated or psychotic patients present a significant challenge to EMS providers
• Physical restraint is associated with significant risk and potential harm to both providers and the patient
• Chemical sedation and restraint can allow proper patient assessment and treatment
• Alternative agent for intoxicated patients, or patients who are unresponsive to midazolam
Haloperidol (Haldol®)
• Classification: 1st generation antipsychotic
• Onset: 5-10 minutes IM
• Duration of action: up to 20 hours
Pharmacology
• Haloperidol is a 1st generation butyrophenone antipsychotic dopaminergic receptor antagonist
Mechanism of Action
• Haloperidol blocks dopaminergic D1 and D2
receptors in the brain;
• Effects basal metabolism, body temperature, wakefulness, vasomotor tone, and emesis
Indications / Contraindications
Indications:
• Acute agitation and psychosis
Contraindications:
• Allergy/hypersensitivity to dopaminergic receptor antagonists
• Parkinson’s Disease
• Coma/CNS depression
• Prolonged QT
Specific information
• Supplied: 5 mg per 1 ml
• Dosing: 2.5 - 5 mg IM
• Pregnancy category C
Other
• Can cause dystonic reaction
– Contact medical control for adverse reaction
• Patients who receive Haldol should be placed on a cardiac monitor when behavior allows
– Watch for QT prolongation
• Haldol may only be given on a physician order
• Haldol will not be restocked at the hospital
Thanks.