DRUG STUDY

GENERIC NAME: Haloperidol Decanoate

Brand name: Haldol, Peridol
Drug Classification: central nervous system agent; psychotherapeutic; antipsychotic;
butyrophenone
Pregnancy Category:C
DOSAGE, ROUTE, SIDE EFFECTS and
FREQUENCY (prescribed and INDICATION MECHANISM OF ADVERSE REACTIONS
recommended) ACTION (by system)
Psychosis Management of Tourette Competitively blocks CNS:Extrapyramidal
adult:PO 0.25 mg b.i.d. or t.i.d. disorders; control of dopamine receptors to reactions: Parkinsonian
IM 25 mg repeated q4h prn; adults; management of cause sedation and also symptoms, dystonia,
Ddecanoate 50100 mg q4wk severe behavioral causes alpha-adrenergic akathisia, tardive dyskinesia
child:PO 0.5 mg/d in 23 divided problems in children and and anticholinergic (after long-term use);
doses, may be increased by 0.5 adults; management of blockade. It depresses insomnia, restlessness,
mg q57d to 0.050.15 mg/kg/d severe behavioral cerebral cortex and anxiety, euphoria, agitation,
Severe Psychosis problems in children; hypothalamus and limbic drowsiness, mental
adult: PO 35 mg b.i.d. or t.i.d., short-term treatment of system, which control depression, lethargy, fatigue,
may need up to 100 mg/d hyperactive children. activity and agression but weakness, tremor, ataxia,
IM 25 mg, may repeat q.h. prn, Long-term antipsychotic also cause significant headache, confusion, vertigo;
Decanoate: 50100 mg q4wk therapy (haloperidol extrapyramidal effects. The neuroleptic malignant
child:PO 0.050.15 mg/kg/d in 23 decanoate). mechanism for syndrome, hyperthermia,
divided doses antipsychotic effects are grand mal seizures,
Dementia Unlabeled uses unclear. exacerbation of psychotic
geriatric: PO 0.250.5 mg 12 Cancer chemotherapy as symptoms.
times daily, may increase every 4 an antiemetic in doses CV:Tachycardia, ECG
7 d (max: 4 mg/d in 23 divided smaller than those changes, hypotension,
doses) required for antipsychotic hypertension (with
Oral effects; treatment of overdosage).
Give with a full glass (240 mL) of autism; alcohol Endocrine:Menstrual
water or with food or milk. dependence; chorea. irregularities, galactorrhea,
Taper dosing regimen when lactation, gynecomastia,
discontinuing therapy. Abrupt impotence, increased libido,
termination can initiate hyponatremia,
extrapyramidal symptoms. hyperglycemia,
Intramuscular hypoglycemia.
Give by deep injection into a large SpecSenses:Blurred vision.
muscle. Do not exceed 3 mL per Hematologic:Mild transient
injection site. leukopenia, agranulocytosis
Have patient recumbent at time of (rare).
parenteral administration and for GI:Dry mouth, anorexia,
about 1 h after injection. Assess nausea, vomiting,
for orthostatic hypotension. constipation, diarrhea,
Store in light-resistant container at hypersalivation.
1530 C (5986 F), unless Urogenital:Urinary retention,
otherwise specified by priapism.
manufacturer. Discard darkened Respiratory:Laryngospasm,
solutions bronchospasm, increased
depth of respiration,
bronchopneumonia,

NURSING RESPONSIBILITIES
CONTRAINDICATION/S (at least 10)
 Contraindications
Parkinsons disease,
parkinsonism, seizure disorders,
coma; alcoholism; severe
mental depression, CNS
depression; thyrotoxicosis. Safe
use during pregnancy (category
C), lactation, or in children <3 y
is not established.
Cautious use
Older adult or debilitated
patients, urinary retention,
glaucoma, severe
cardiovascular disorders;
patients receiving
anticonvulsant, anticoagulant,
or lithium therapy.
Monitor for therapeutic effectiveness. Because of long half-life,
therapeutic effects are slow to develop in early therapy or when
established dosing regimen is changed. Therapeutic window effect
(point at which increased dose or concentration actually decreases
therapeutic response) may occur after long period of high doses.
Close observation is imperative when doses are changed.
Target symptoms expected to decrease with successful haloperidol
treatment include hallucinations, insomnia, hostility, agitation, and
delusions.
Monitor patients mental status daily.
Monitor for neuroleptic malignant syndrome (NMS) , especially in
those with hypertension or taking lithium. Symptoms of NMS can
appear suddenly after initiation of therapy or after months or years of
taking neuroleptic (antipsychotic) medication. Immediately
discontinue drug if NMS suspected.Monitor for parkinsonism and
tardive dyskinesia . Risk of tardive dyskinesia appears to be greater in
women receiving high doses and in older adults. It can occur after
long-term therapy and even after therapy is discontinued.
Monitor for extrapyramidal (neuromuscular) reactions that occur
frequently during first few days of treatment. Symptoms are usually
dose related and are controlled by dosage reduction or concomitant
administration of antiparkinson drugs.
Be alert for behavioral changes in patients who are concurrently
receiving antiparkinson drugs.
Monitor for exacerbation of seizure activity.
Observe patients closely for rapid mood shift to depression when
haloperidol is used to control mania or cyclic disorders. Depression
may represent a drug adverse effect or reversion from a manic state.
Lab tests: Monitor WBC count with differential and liver function in
patients on prolonged therapy.
Patient & Family Education
Avoid use of alcohol during therapy.
Do not drive or engage in other potentially hazardous activities until
response to drug is known.
Discuss oral hygiene with health care provider; dry mouth may
promote dental problems. Drink adequate fluids.
Avoid overexposure to sun or sunlamp and use a sunscreen; drug can
cause a photosensitivity reaction.
Do not breast feed while taking this drug without consulting physician.
Chapter II
Duration of 4 Weeks
Depot injection 2-4 weeks to take effect.
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Patients Name / Room No.