Haloperidol Mnemonic: Key Facts, Side Effects, and Dosing Guide

To remember the drug Haloperidol, use the mnemonic “Halo Person Dulls Overload":

• Halo: Haloperidol
• Person: Think of a patient
• Dulls: Haloperidol is an antipsychotic, which dulls hallucinations
• Overload: Used for conditions like schizophrenia, where there’s a dopamine overload

For a nursing-focused breakdown of typical antipsychotics, check out this video:

Video Summary

Typical antipsychotics, including haloperidol and fluphenazine, are used to treat conditions such as:

• Schizophrenia
• Psychosis
• Severe agitation and aggression

While effective, they come with significant side effects, particularly extrapyramidal symptoms (EPS) and neuroleptic malignant syndrome (NMS).

Adverse Side Effects of Haloperidol

• Extrapyramidal Symptoms (EPS): Movement disorders such as dystonia, akathisia, and tardive dyskinesia.
• Neuroleptic Malignant Syndrome (NMS): A rare life-threatening condition with symptoms like fever, muscle rigidity, and autonomic instability.
• Sedation & Drowsiness
• Prolonged QT Interval: Increases the risk of Torsades de Pointes. Mnemonic for drugs causing QT prolongation: "ABCD"
  • A - AntiArrhythmics (Amiodarone, Dofetilide, Procainamide)
  • B - AntiBiotics (Azithromycin, Clarithromycin, Erythromycin)
  • C - AntiCychotics (Haloperidol, Olanzapine, Quetiapine)
  • D - AntiDepressants (Amitriptyline, Citalopram, Imipramine)
• Anticholinergic Effects: Dry mouth, constipation, urinary retention, and blurred vision.

Dosing

• Haloperidol alone
  • Child: 0.05 to 0.15 mg/kg PO/IM/IV (up to 2-5 mg for teen)
  • Adult: 5 mg IV or 10 mg PO/IM prn
  • May repeat dose in 10 to 30 minutes if needed
  • Consider with Benadryl 50 mg or Cogentin 1 mg to prevent Dystonic Reaction
  • Monitor Electrocardiogram for QTc Prolongation (esp. IV dosing, risk of Torsades de Pointes)
• Haloperidol with Midazolam and Benadryl q30 minutes prn
  • Benadryl 50 mg (prevents Dystonia)
  • Haloperidol 5 mg (up to 10 mg)
  • Midazolam 2 mg (up to 4 mg) - Midazolam is preferred over Ativan for IM Benzodiazepine)
  • Draw up the 3 agents into same syringe and deliver IM - May repeat once with additional 5 mg Haloperidol and 2 mg Midazolam

For more dosing guidelines for treating chronic psychosis or tourette syndrome, check out this clinical guide on Haloperidol.

Minimizing Anticholinergic Side Effects

To reduce anticholinergic effects in elderly patients, consider using high-potency substances (e.g., haloperidol, risperidone) or melperone, as they tend to have fewer anticholinergic effects than low-potency options.

Check this out for a deeper dive into managing anticholinergic side effects.