Elegant manual

S . C . R . E . T . A . C . / S . E . C . R . E . T . A . C M E D I C A L T R E A T M E N T P R O T O C O L S
U P D A T E D : 4 / 2 5 / 2 0 1 3
K . W E B E R , M D D . W I L S O N , M D
Classification Major tranquilizer Pharmacology and action Haldol is one of the butyrophenone series of major tranquilizers. The effects include anti-anxiety, mild sedation, and neuroleptic reactions. Neuroleptic syndrome consists of suppression of spontaneous movements and complex behavior – while spinal reflexes and unconditioned nociceptive-avoidance behavior remains intact. Neuroleptic drugs reduce initiative and interest in the environment, and they reduce displays of emotion or affect. Haldol blocks dopamine receptors in the brain that are responsible for mood and behavior. Haldol also has some antiemetic properties. Indications 1. Chemical restraint for severely agitated patient. Contraindications (in addition to having a known hypersensitivity to this medication or this class of medication) 2. Do not use in pregnant or lactating women. 1. Administer with caution to patients with history of severe cardiovascular disease – may produce hypotension or angina. Fluids should be available to treat hypotension, which is an occasional side effect. QT prolongation has been reported. 2. Use caution if the patient has already taken narcotics or other tranquilizers. S . C . R . E . T . A . C . / S . E . C . R . E . T . A . C M E D I C A L T R E A T M E N T P R O T O C O L S
U P D A T E D : 4 / 2 5 / 2 0 1 3
K . W E B E R , M D D . W I L S O N , M D

Haloperidol, like other major tranquilizers of the phenothiazine class, can produce significant
extrapyramidal (distonic) symptoms within 12-48 hours. Spasm of the muscles of tongue, face,
neck, and back are the most common. The symptoms can be mild or severe. Diphenhydramine
(see diphenhydramine protocol) may be needed to reverse extrapyramidal effects.
Multiple other neurological effects of these (neuroleptic) drugs include Parkinsonism, akathisia,
tardive dyskinesia, and neuroleptic malignant syndrome. These complications occur with
prolonged treatment regimens, not with one-time emergency use of haloperidol.
Hyperpyrexia and heat stroke may be an uncommon, but abrupt complication.
As with all tranquilizing drugs, the effects with other sedatives are additive and there is always
the possibility of respiratory depression. Haloperidol should only be administered when the
patient will be under close observation with airway adjuncts at hand.
Special Notes
1. Hepatic metabolism and excreted primarily in urine. 2. Onset of action is 20-30 minutes. Full effect may not be apparent for 1-2 hours. 3. Duration of effect may up to 4 hours. 4. EMT-B+’s and/or EMT-I’s may administer this medication under the DIRECT supervision of an EMT-Paramedic (as long as the EMT-B+/EMT-I have received prior training on the use/administration of this medication).

Source: http://pcemscouncil.com/Protocols/9.39_Haloperidol.pdf

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