Haldol Lactate [Rx] Classification: Antipsychotic, buty-rophenone
Action/Kinetics: Precise mechanism not known. Haloperidol competitively blocks dopamine receptors to cause sedation. Also causes al-pha-adrenergic blockade, decreases release of growth hormone, and increases prolactin release by the pituitary. Causes significant extrapyramidal effects, as well as a low incidence of sedation, anticholinergic effects, and orthostatic hypotension. Narrow margin between the thera-peutically effective dose and that causing extrapyramidal symptoms.
Also has antiemetic effects. Peak plasma levels: PO, 3-5 hr; IM, 20 min; IM, decanoate: approximately 6 days. Therapeutic serum levels
3-10 ng/mL. tv2, PO: 12-38 hr; IM 13-36 hr; IM, decanoate: 3 weeks; IV: approximately 14 hr. Plasma protein binding: 90%. Metabolized in liver, slowly excreted in urine and bile.
Uses: Psychotic disorders including manic states, drug-induced psychoses, and schizophrenia. Aggressive and agitated clients, including chronic brain syndrome or mental retardation. Severe behavior problems in children (those with combative, explosive hyperexcitability not accounted for by immediate provocation). Short-term treatment of hyperactive children. Control of tics and vocal utterances associated with Gilles de la Tourette's syndrome in adults and children. The decanoate is used for prolonged therapy in chronic schizophrenia.
Contraindications: Use with extreme caution, or not at all, in clients with parkinsonism. Lactation. Special Concerns: PO dosage has not been determined in children less than 3 years of age; IM dosage is not recommended in children. Geriatric clients are more likely to exhibit or-thostatic hypotension, anticholiner-gic effects, sedation, and extrapyramidal side effects (such as parkinsonism and tardive dyskinesia). Side Effects: Extrapyramidal symptoms, especially akathisia and dys-tonias, occur more frequently than with the phenothiazines. Overdos-age is characterized by severe extrapyramidal reactions, hypotension, or sedation. The drug does not elicit photosensitivity reactions like those of the phenothiazines.
Drug Interactions Amphetamine / l Effect of amphet amine by l uptake of drug at its site of action
Anticholinergics / l Effect of halo-peridol
Antidepressants, tricyclic / T Effect of antidepressants due to l breakdown by liver
Barbiturates / l Effect of haloperi-dol due to T breakdown by liver Phenytoin / l Effect of haloperidol due to T breakdown by liver How Supplied: Haloperidol: Tablet: 0.5 mg, 1 mg, 2 mg, 5 mg, 10 mg, 20 mg. Haloperidol decanoate: Injection: 50 mg/mL, 100 mg/mL. Haloper-idol lactate: Concentrate: 2 mg/mL; Injection: 5 mg/mL; Solution: 1 mg/mL
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