Haloperidol: A safer alternative for delirium
One drug all hospitals might consider using to calm patients in the intensive care unit is intravenous haloperidol. Unlike narcotics or traditional sedatives, haloperidol causes few cardiac or respiratory side effects. True, the IV route isn’t an approved use, but according to literature reports, IV haloperidol is well-tolerated in ICU patients.
Clinicians need to worry about three main side effects, none of which commonly occur: extrapyramidal symptoms, which occur less frequently via the IV route than PO; neuroleptic malignant syndrome, which so far has occurred in just one IV patient; and torsades de pointes, which may be connected to high doses of either IV or PO haloperidol.
Here’s one published regimen for haloperidol IV: 2.5 mg to 5 mg IV by slow push (two to three minutes), with doses adjusted for severity of symptoms. Double this dose every 20 to 30 minutes as necessary until the patient is calm. Whatever dose is finally used in the escalation in other words, whatever dose actually calms the patient will become the maintenance dose, given every four hours as needed.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content