Haldol – a Nurse’s Best Friend

Vitamin HH letter

What are some of the main indications for Haldol use?

  • Uses the callbell too often
  • Talks too long
  • Repeatedly comes out of room to find nurse

No – really – just kidding!

Official indications for Haldol administration is to gain therapeutic control of the patient whose behavior may be a danger to themselves.

In hospital – Haldol (haloperidol lactate) – fast acting antipsychotic – pharmacological class: Butyrophenone – Old Faithful

 

Indications Schizophrenia (Moderate), Psychosis Schizophrenia (Severe), Psychosis ICU Delirium Ticks and outbursts as in Tourette’s Dementia related psychosis
PO 0.5-2mg Q8-12H prn 3-5mg Q8-12H prn – up to 30mg/day 0.5-2mg Q8-12H initially. May need to increase to 3-5mg Q8-12H. Some have had up to 100mg/day. Not approved due to increased risk of death
IM 2-5mg Q4-8H prn (may require Q1H prn initially) See note below table Not approved
IV (off-label) 2-10mg initially. May repeat Q15-30min (doubling initial dose sequentially. Then 25% of last bolus Q6H & taper off as able) Monitor EKG for prolonged QT intervals. Not approved
Geriatric dosages 0.25-0.5mg Q8-12H initially Less and less often than adults under age 65 0.25-0.5 Q4H & watch EKG for prolonged QT intervals Not approved
Negative (potential) side effects EPS, Tardive dyskinesia, Prolonged QT interval, Torsades de Pointes, Neuroleptic Malignant Syndrome (NMS), can affect blood, blood pressure, GI, liver, skin, endocrine, electrolyte balance, ability to drive -> -> -> ->Highest risk group for Tardive dyskinesia, Death
Contraindications CNS depression, coma, Parkinson’s -> -> -> ->
Use caution in patients with Allergy to Haldol, severe CV disorders, neutropenia, seizure disorder on meds -> -> -> ->
Potential interactions Neurotoxicity if on Lithium, potentiated by many other meds
Storage In syringe, in your pocket (just kidding!)

If Haldol is being given to a person with bipolar in the manic phase, they could quickly move to depressive phase after receiving med.

IM or PO haloperidol decanoate (depot)  is for home use – not for hospital use. Dosages are different and it is longer acting.

Thanks to: RxList.com ,  MedScape.com ,  and Drugs.com .

So there is your handy-dandy snapshot of Haldol – a nurse’s best friend! (when used with caution) Here’s a great resource to find out more: Mosby’s 2015 Nursing Drug Reference, 28e (SKIDMORE NURSING DRUG REFERENCE)

Thanks for checking in! Let me know if you want more med summaries like this.

Cheers!

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3 Responses

  1. All nurses understand this bit, we do. There are far more effective options to shape patient attitudes and behavior, though, ones that we can actually use! If willing to learn a bit.

    • Exactly – thank you for your comment! And the underlying point, which I hope came across, was for the potential side effects to be kept in mind before giving each dose. And while Haldol can sometimes be used to prevent injuries, it certainly is no cure-all.

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