HALOPERIDOL

A butyrophenone with longer duration of action than droperidol. It has anti-emetic and neuroleptic effects with minimal cardiovascular and respiratory effects. It is a mild α-blocker and may cause hypotension in the presence of hypovolaemia.

Uses

Acute agitation and delirium

Contraindications

QT prolongation, torsades de pointe, ventricular arrhythmias, agitation caused by hypoxia, hypokalaemia or a full bladder

Parkinson's disease

Administration

1. • IV bolus: 2.5–5 mg

2. • IV infusion: 30 mg in 50 ml of glucose 5% at a rate of 0–10 mg/h (unlicensed administration)

3. • IM: 5–10 mg

Up to every 4–8 h

How not to use haloperidol

Hypotension resulting from haloperidol should not be treated with adrenaline as a further decrease in BP may result

Adverse effects

Extra-pyramidal movements

Neuroleptic malignant syndrome (treat with dantrolene)

Prolongation of QT interval

Cautions

Concurrent use of other CNS depressants (enhanced sedation)

Organ failure

CNS: sedative effects increased

Hepatic: can precipitate coma

Renal: increased cerebral sensitivity

Renal replacement therapy

No further dose modification is required during renal replacement therapy

HEPARIN

Uses

Prophylaxis of DVT and PE

Treatment of DVT and PE

Extracorporeal circuits