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.