HALOPERIDOL( HALDOL, SERENACE): ACTION AND USES

 HALOPERIDOL( HALDOL, SERENACE)

THERAPEUTIC CLASS

• Conventional antipsychotic; schizophrenia drug

PHARMACOLOGIC CLASS

• D2 dopamine receptor antagonist; nonphenothiazine

ACTION AND USES OF HALOPERIDOL( HALDOL, SERENACE)

Haloperidol is classified chemically as a butyrophenone. Its primary use is for the management of acute and chronic psychotic disorders. It may be used to treat patients with Tourette's syndrome and children with severe behaviour problems such as unprovoked aggressiveness and explosive hyperexcitability. It is approximately 50 times more potent than chlorpromazine but has equal efficacy in relieving symptoms of schizophrenia. Haldol/Serenace LA is a long-acting preparation that lasts approximately 3 weeks following IM or subcutaneous administration. This particularly beneficial for patient who are uncooperative or unable to take oral medications.

ADMINISTRATION ALERT Haldol or Serenace

• Don not abruptly discontinue, or severe adverse reactions may occur.
• The patient must take the medications as ordered for therapeutic results to occur.
• If the patient does not comply with oral therapy, injectable extended-release haloperidol should be considered.
• Pregnancy category C.

PHARMACOKINETICS

• ONSET: 30-35 min
• PEAK: 2-6 h PO; 10-20 min IM
• DURATION: Variable

ADVERSE EFFECTS

Haloperidol produces less sedation and hypotension than chlorpromazine, but the incidence of EPS is high. Older adults are more likely to experience adverse effects and often are prescribed half the adult dose until the adverse effects of therapy can be determined. Although the incidence of NMS is rare, it can occur.

BLACK BOX WARNING

• Elderly patients with dementia-related psychosis are at increased risk for death when taking conventional antipsychotis.

CONTRAINDICATIONS

• Pharmacotherapy with nonphenothiazines is not advised if the patient is receiving medication for any of the following conditions: Parkinson's disease, seizure disorders, alcoholism and severe mental depression.

INTERACTIONS

Drug-Drug: Haloperidol interacts with many drugs. For example, the following drugs decrease the effects/adsorption of haloperidol: aluminum and magnesium-containing antacids, levodopa, lithium, phenobarbital, phenytoin, rifampin, and beta-blockers. Haloperidol inhibits the action of centrally acting antihypertensives.

Treatment of Overdose

In general, the symptoms of overdose are an exaggeration of known pharmacologic effects and adverse reactions, the most prominent of which would be severe extrapyramidal reactions, hypotension, or sedation. With EPS, anti parkinsonism medication should be administered. Hypotension should be counteracted with IV fluids, plasma, or concentrated albumin, or vasopressor drugs.