Haloperidol

Description overdue on 04.06.2012

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Neuroleptics, antipsychotic . The active ingredient is butyrophenone derivatives. Haloperidol blocks dopamine, the postsynaptic receptors in mesocortical, mesolimbic brain structures, and has a strong anti-psychotic effects. Despite the high antipsychotic activity , The drug combines a moderate sedative and antiemetic effects. Haloperidol has no anticholinergic influence, but causes extrapyramidal disorder. Sedation due to the blockade in the reticular Pharmacy alpha-adrenergic receptors. Antiemetic effect   It achieved a blockade of the vomiting center in the trigger zone. When the blockade of dopamine receptors in gipotalamasu appears galactorrhea and hypothermic influence. When long-term therapy changes the endocrine status, reduced production of gonadotropin-releasing hormone and intensifies the synthesis of prolactin   thanks to the influence on the anterior lobe. Haloperidol decanoate longer-acting in comparison with haloperidol. The drug eliminates persistent personality changes, delusions, hallucinations, delusions, reinforces the interest of the patient to the outside world. Haloperidol is prescribed to patients who have developed resistance to other neuroleptic drugs. The drug has an activating effect on patients. In hyperactive children Haloperidol is able to eliminate behavioral disorders, excessive motor activity. Therapeutic influence of prolonged forms of the drug lasts up to 6 weeks. Haloperidol is available as a tablet, liquid, droplets.

Indications:

Haloperidol is prescribed for hallucinations , Delirium, acute psychosis, paranoid states , Psychomotor agitation, "steroid" psychosis, alcohol and drug psychosis at agitated depression, mental retardation, Tourette's syndrome , Psychoses, of various origins, with Huntington's chorea , Psychosomatic disorders, stuttering, childhood autism , Hyperactivity in children.

Contraindications:

Haloperidol is not applicable for severe CNS depression, intolerance to the active substance in the pathology of the central nervous system, which is accompanied by extrapyramidal and pyramidal symptoms, and breastfeeding , Hysteria, depression, Parkinson's disease, pregnancy, children under three years. In case of violation of intracardiac conduction, angina, lengthening the interval QT, angle-closure glaucoma, with hypokalemia, decompensated heart disease, epilepsy, hyperthyroidism, renal disease and liver, respiratory and cardiopulmonary diseases, alcoholism, prostatic hyperplasia with urinary retention , acute infectious diseases, COPD Haloperidol used with caution.

Side effect:

Nervous system:   drowsiness, headache, agitation, anxiety,   akathisia , Fears, anxiety, worsening of hallucinations, psychosis, lethargy, depression or euphoria , Epilepsy, tardive dyskinesia, a long-term therapy are marked extrapyramidal disorder, tardive dystonia (spasms of the eyelids, frequent blinking, uncontrolled movements of the arms, legs, torso, neck) neuroleptic malignant syndrome   (loss of consciousness, incontinence, urination, palpitations or shortness of breath, sweating, unstable blood pressure, arrhythmia, tachycardia , Hyperthermia, seizures, muscle rigidity). Cardiovascular system:   signs flicker and flutter on the ECG ventricular tachycardia, arrhythmia, orthostatic hypotension , Drop in blood pressure. Digestive system: constipation , Dry mouth, loss of appetite, sialoschesis, diarrhea, nausea, vomiting, disorders of the liver. Bodies of blood:   tendency to monocytosis, erythropenia, agranulocytosis, leukocytosis, leukopenia - a temporary nature. Urogenital:   priapism, increased libido, or reduced potency, menstrual disorders in females, hyperprolactinemia . gynecomastia , Pain in the breasts, peripheral edema, with prostatic hyperplasia observed urinary retention. Allergic reactions, photosensitization , Laryngospasm, bronchospasm, maculopapular skin changes, blurred vision, retinopathy, cataracts, hyponatremia, hypoglycemia, weight gain, alopecia.

Overdose:

Manifested by tremor, muscle stiffness , Drop in blood pressure. In severe cases registered shock, respiratory depression, coma. Requires gastric lavage, the appointment of enterosorbents. Norepinephrine and albumin are used to improve blood circulation. Inadmissibility of the use of epinephrine. Antiparkinsonian and central holinoblokatory can reduce the severity of extrapyramidal symptoms.   Dialysis   not proved effective.

Mode of application:

Haloperidol is taken orally, with a full glass of milk, water. The initial dose is at 0, 5-5 mg three times a day. In no more than 100 mg per day. The duration of therapy is 2-3 months. The drug is cancel gradually reduce the dosage slowly move on to receive maintenance doses - 5.10 mg per day. Tourette's disease, psychotic disorders in behavior 2-3 times per day 0, 05mg / kg / day, with gradual dose increases to 0, 1, 5 mg once a week to the maximum 0, 075 mg / kg / day. The average single dosage for intramuscular administration is 2-5 mg of haloperidol, the interval between injections - 48 hours. Acute alcoholic psychosis: 5-10 mg intravenously.

Special instructions:

It requires regular monitoring of the level of "liver" sampling, monitoring of the dynamics of an electrocardiogram, blood parameters. Parenteral administration of the drug is carried out only under the control of the attending physician. After a therapeutic effect on the admission tablet form of the drug. In the case of late registration   dyskinesia   during treatment requires a gradual reduction in dosage until the complete cessation. When taking a hot bath can heat stroke because of the suppression of the peripheral and central regulators, located in the hypothalamus. Requires careful when performing heavy physical work type. Not recommended for use over the counter 'cough' preparations for the entire period of treatment because of the risk of heat stroke, enhance anticholinergic effects. Because of the risk of photosensitivity in patients is necessary to protect exposed skin from the action of sunlight. Haloperidol lifted gradually in mind the risk of the syndrome of "cancellation". Often anti-emetic effect of the drug masks the symptoms drug toxicity And difficult to diagnose conditions that are accompanied by nausea. Haloperidol may precipitate when mixed solution with tea and coffee. Before the appointment of long-acting form of the drug the patient is transferred to haloperidol with other antipsychotic drugs for the prevention of sudden hypersensitivity to the drug. The drug affects the control of motor vehicles.

Drug Interactions:

Haloperidol increases the severity of the oppressive effects of sleeping pills, barbiturates, opioids Tricyclic antidepressants, ethanol, means for general anesthesia on the central nervous system. The drug enhances the effect of antihypertensive drugs, Mr. holinoblokatorov inhibits the metabolism of MAO inhibitors, tricyclic antidepressants,   wherein mutually increases their toxicity and sedative effect. Buprorion in combination with haloperidol increases the probability of occurrence of large seizures, reduces epileptic threshold. Preparation weakens vasoconstrictive effect of norepinephrine, phenylephrine, dopamine, epinephrine. The medicament reduces efficiency anticonvulsants , Antiparkinsonian, change the effect of anticoagulants. The risk of developing mental disorders increases with the appointment of the drug methyldopa. Amphetamines are able to reduce the impact of antipsychotic haloperidol. By drinking strong coffee, tea marked decrease in the efficiency of haloperidol. Protivoparkinsonicheskogo, antihistamines, anticholinergics increase m-anticholinergic effects of neuroleptics reduce the severity of its antipsychotic effect. With prolonged use of inducers of microsomal oxidation, barbiturates, carbamazepine   reduced concentration neuroleptic levels. In combination with lithium may form encephalopathy, increased severity of extrapyramidal disorders. Fluoxetine   It can increase the severity of extrapyramidal symptoms, side effects of the nervous system. Appointment of drugs that cause extrapyramidal reactions, leads to an increase in the severity and frequency extrapyramidal disorders .