Haldol

1. Haloperidol (Haldol®)
Kevin Collins, MD PhD
For the
REMO Medical Advisory Committee

2. 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

3. Haloperidol (Haldol®)
• Classification: 1st generation antipsychotic
• Onset: 5-10 minutes IM
• Duration of action: up to 20 hours

4. 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

5. Indications / Contraindications
Indications:
• Acute agitation and psychosis
Contraindications:
• Allergy/hypersensitivity to dopaminergic
receptor antagonists
• Parkinson’s Disease
• Coma/CNS depression
• Prolonged QT

6. Specific information
• Supplied: 5 mg per 1 ml
• Dosing: 2.5 - 5 mg IM
• Pregnancy category C

8. 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

9. Thanks.